Program Objectives

1. To provide a program of training which will prepare physicians for certification by the American Board of Surgery for practice in the specialty of Surgery and as a prerequisite for further training in other surgical specialties or subspecialties.
   
2. To provide designated preliminary training for physicians who are accepted into residency training programs requiring or accepting one or more years of prerequisite surgical experience.
   
3. To provide undesignated preliminary training for one or two years for selected physicians who wish to complete residency training in a surgical specialty but who have not yet been accepted into a surgical training program. The pursuit of a surgical education is both physically and intellectually challenging. Rarely is one’s performance flawless, but we expect our residents to make both an honest effort and good progress towards attainment of all educational objectives.We insist that the following critical requirements be met by all members of our professional community, regardless of level of training. These requirements are so crucial that the inability to meet any one of them may be cause for dismissal from our program. These critical requirements are:
   1. Residents must act with complete honesty and integrity in the treatment of patients and in research.
   2. Residents must act in accordance with the responsibilities inherent in the surgeon-patient relationship.
   3. Residents must interact in a professional manner with physicians, students, nurses and other members of the healthcare team.

ACGME General Competencies

The Accreditation Council for Graduate Medical Education (ACGME) has identified the following six general competencies that describe the general outcomes expected in the conduct of Graduate Medical Education. Specific expectations of the Residency Review Committee for Surgery are listed in parenthesis following each General Competency description. By completion of training, residents must become competent in these six areas at the level expected of an entry-level surgical practitioner.

1. Patient Care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health. Surgical residents must demonstrate manual dexterity appropriate for their training level and be able to develop and execute patient care plans.
2. Medical Knowledge about established and evolving biomedical, clinical and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care. Surgical residents are expected to critically evaluate and demonstrate knowledge of pertinent scientific information.
3. Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence and improvements in patient care. Surgical residents are expected to critique personal practice outcomes and demonstrate a recognition of the importance of lifelong learning in surgical practice.
4. Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families and other healthcare professionals. Surgical residents are expected to communicate effectively with other healthcare professionals, counsel and educate patients and families and effectively document practice activities.
5. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient population. Surgical residents are expected to maintain high standards of ethical behavior, demonstrate a commitment to continuity of patient care and demonstrate sensitivity to age, gender and culture of patients and other healthcare professionals.
6. Systems-Based Practice as manifested by actions that demonstrate an awareness of and response to the larger context and system of health care and effectively call on system resources to provide optimal care. Surgical residents are expected to practice high quality, cost effective patient care, demonstrate knowledge of risk-benefit analysis and demonstrate an understanding of the role of different specialists and other healthcare professionals in overall patient management. 

General Educational Objectives of the UAMS Surgery Residency Program

The following general educational objectives amplify the expectations of the ACGME General Competencies and apply to residents at all levels. These objectives characterize the general requirements for successful completion of our residency program. A continuum of achievement in accomplishing these goals throughout residency training will serve as one marker of satisfactory progress.

1. The ability to evaluate surgical patients, including recognition of medical or surgical emergencies which threaten life or limb and require initiation of emergency medical or surgical care.
   
2. The ability to develop, defend and carry out a rational plan of care for surgical patients.
   
3. The ability to understand and participate in surgical education and research. All residents are expected to develop proficiency in the use of surgical literature. Categorical residents are expected to complete one project that is accepted for publication in a peer-reviewed journal or presented at a major surgical meeting prior to completion of residency training.
   
4. Demonstration of a humane and considerate approach to patients and family members.
   
5. Proficiency in written and oral communication in bedside care, case presentations, the medical record and manuscripts.
   
6. Satisfactory and timely completion of medical record responsibilities.

PGY Year Specific Educational Objectives of the UAMS Surgery Residency Program

The following yearly educational objectives characterize our specific expectations for the professional maturation of our residents. Promotion (or program completion in the case of PGY-5 residents) will generally be dependent on satisfactory achievement of these objectives.

PGY-1 residents are expected to accomplish and maintain the following objectives:

1. Establish basic proficiency in the evaluation of patients under routine and emergency circumstances (recognizes surgical emergencies, performs a history and physical examination, orders appropriate basic ancillary studies, effectively communicates findings to other physicians.
   
2. Establish basic proficiency in providing pre-operative and post-operative care (writes appropriate pre-op and post-op orders for floor patients, handles nursing calls appropriately, manages most routine post-operative care with minimal intervention by supervisors).
   
3. Develop a working knowledge of common problems in general surgery, vascular surgery, cardiothoracic surgery, surgical oncology and pediatric surgery (achieves acceptable grade on rotation evaluation).
   
4. Establish a working knowledge and familiarity with common procedures of the surgical specialties (achieves acceptable grade on rotation evaluation).
   
5. Acquire basic operative skills necessary to perform less complex surgical procedures, such as hernia repair, central line procedures and minor outpatient surgery (assessed by direct observation by faculty or senior resident).
   
6. Develop a working knowledge of and familiarity with the management of common problems in plastic and reconstructive surgery (achieve specific goals and objectives on this service, assessment of technical skills by direct observation).
   
7. Develop personal values and interpersonal skills appropriate for the surgical resident (is available at required times, gives patient care needs highest priority, complies with department and university policy, is not subject of excessive or substantial complaints from patients, families or other members of the healthcare team).

PGY-2 residents are expected to accomplish and maintain the following objectives:

1. Develop enhanced proficiency in the provision of pre-operative and post-operative care (manages pre-operative and post-operative care of complex patients with minimal intervention by supervisors).
   
2. Establish a knowledge-based and skill proficiency for the management of the critically ill surgical patient and the burned patient (achieves acceptable grade on rotation evaluation, can place endotracheal tube, S-G catheters, arterial lines and perform escharotomy).
   
3. Develop organizational and teaching skills necessary for basic management of a surgical service (attends efficiently to organizational duties of service such as organizing rounds and teaching sessions, participates in organized teaching activities for medical students under faculty supervision).
   
4. Acquire proficiency in surgical endoscopy (successfully performs colonoscopy, EGD, anoscopy, bronchoscopy).
   
5. Develop a working knowledge of and familiarity with the management of common problems in thoracic surgery (achieve specific goals and objectives on this service, perform uncomplicated general thoracic surgical procedures).
   
6. Develop increased skill in operative technique required for procedures of increasing surgical complexity, such as skin grafting, more complex hernia repairs and complex soft tissue surgery (is able to perform these operations with minimal assistance).

PGY-3 residents are expected to accomplish and maintain the following objectives:

1. Continues to develop technical skills necessary for the performance of more complex surgical procedures in general, vascular and minimally invasive surgery (performs laparoscopic cholecystectomy, small bowel resection, uncomplicated aneurysm repair and other procedures of similar complexity).
   
2. Establish a knowledge base, judgment and interpersonal skills necessary to function as a surgical consultant (successfully manages simple consults with minimal help).
   
3. Develop enhanced skills in the management of a surgical service (manages service administrative duties assigned by chief resident or faculty).
   
4. Develop knowledge and skills necessary for function as the trauma team leader for adult patients (successfully directs trauma resuscitations with faculty supervision and review).
   
5. Demonstrates proficiency in the rational use of surgical literature and evidence-based medicine (defends discussions and recommendations with scientific evidence).

PGY-4 residents are expected to accomplish and maintain the following objectives:

1. Continue to develop knowledge and skills necessary for the complete management of common problems in general surgery, vascular surgery, pediatric surgery, thoracic surgery and surgical oncology (manages most common problems in these specialties with minimal assistance).
   
2. Develop knowledge and skills necessary for function as the trauma team leader for pediatric patients (successfully directs trauma resuscitations with faculty supervision and review).
   
3. Demonstrates satisfactory performance as a teacher of junior residents and medical students (receives acceptable feedback from students and peers).
   
4. Demonstrates interpersonal skills and conduct required for surgical practice in the private practice setting (receives individual feedback and acceptable rotation evaluation from private surgery faculty).

PGY-5 residents are expected to accomplish and maintain the following objectives:

1. Develop knowledge and skills necessary to assume complete responsibility for the management of the surgical patient, including mastery of the fundamental components of surgery as defined by the American Board of Surgery (achieves acceptable score on written and oral examinations and receives acceptable rotations evaluations).
   
2. Demonstrates proficiency in management of complex problems in general surgery, vascular surgery, surgical oncology and trauma (treats complex problems in the discipline with minimal help).
   
3. Demonstrates personal and professional responsibility, leadership skills and interpersonal skills necessary for independent practice as a specialist in surgery (successfully manages the chief resident services).