 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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