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Progressive Responsibility

The General Surgery residency program is designed to provide increasing responsibility commensurate with the resident's level of education. The major responsibilities of a first-year resident include:

• improving clinical skills (history taking and physical diagnosis)
• performing pre- and post-operative care using sound basic surgical principles
• learning the indications for, and the details of, the performance of surgical procedures
• performing minor surgical procedures under faculty supervision
• recognizing the complications of surgery

The core program and the surgical skills educational program augment the activities in the clinical setting.

A second-year resident continues to develop the clinical and technical skills described above. In addition, he/she is introduced to more complex types of patient care that include burn and multiple trauma; pediatric surgery; cardiac surgery; and renal transplantation. As the resident’s skill and proficiency develop, he/she performs more difficult surgical procedures under faculty supervision, learning the details of technical surgical procedures in relation to detailed anatomical knowledge.

A third-year resident assumes more responsibility for total patient care, including care of the critically ill patient. Residents perform major operations such as cholecystectomy, intestinal resection, anastomosis, and surgery of the colon under faculty supervision. The resident is expected to know the intimate details regarding the indications for, and the performance of, technical procedures. The third-year resident will act as the Chief Resident in the Chief’s absence.

The operative experiences of a fourth-year resident intensify as their skill in the area of total patient management continues to develop. While always under the supervision of attending faculty, the senior resident begins to make more independent decisions regarding patient care. Faculty supervision becomes less direct as the resident demonstrates increased proficiency. The senior resident is responsible for total patient care with accountability on the Trauma Service. There is also an opportunity for a six-week elective experience during the senior year.

Chief Residents are responsible for the organization and direction of the clinic services at Sentara Norfolk General and for the management of the surgical service, surgical housestaff, and student team at Sentara Leigh. The Chief Resident also spends a three-month rotation on the Vascular Surgery Service. Chief Residents are responsible for the decision-making, investigation, and management of the patients on their service and for the continuity of care in the outpatient department. The Chief Resident sees all consultations to the service and performs more major surgical procedures. The Chief delegates appropriate procedures to junior residents. The Chief may act in the role of teaching assistant to junior residents when performing minor surgical procedures. Major procedures continue to be performed under the close supervision of our faculty.

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