General Surgery

The residency program in general surgery is an integrated program that uses the facilities of several hospitals of the McGaw Medical Center of Northwestern University. Many of the staff members at these institutions are on faculty at Northwestern University Feinberg School of Medicine. Northwestern medical students, surgical residents, and surgical faculty members form teams to teach, learn, and provide care for surgical patients. First-year positions in general surgery and the surgical specialties are offered through the National Resident Matching Program.


The goal of the general surgery residency program is to prepare highly qualified men and women for careers in surgery. Residents ultimately may seek one of several surgical careers such as private practice, academic surgery, institutional practice, or other employment. However, becoming an excellent clinical surgeon is a prerequisite for success in any of these or other practice settings, and the Northwestern program is designed to meet this need. The department also meets individual needs for those who desire a specific surgical career or want preparation for an additional surgical fellowship or specialty experience.

Residency Program

The program provides a firm grounding in the pathophysiology of surgical diseases and trauma, with the necessary basic science instruction to understand the systemic responses to illness, surgery, and trauma.

Surgical care and diagnosis are emphasized at the beginning of the program. First-year residents examine new patients and treat patients whose conditions have changed. Early experience in the operating room teaches residents the essentials of surgical technique. As residents progress through the program, they take on increased responsibility and authority. During the middle years, residents may be in charge of a service, performing major surgical procedures (many are laparoscopic and minimally invasive) with the assistance and supervision of an attending faculty member. The progression of responsibility and involvement in increasingly complex cases culminates in the fifth and final year as chief resident. The chief resident, under appropriate supervision, has independent responsibility for patients and heads a surgical service. The chief resident also is responsible for teaching medical students and junior residents, conducting bedside rounds, and managing other administrative activities. The chief resident receives a medical school faculty appointment as instructor in surgery.

Rotations during the first year include general surgery, anesthesiology, emergency/trauma, and several surgical specialties. Specialty rotations are interspersed with general surgery during the second and third years. In addition, residents in the second through fifth years receive instruction and hands-on practice in laparoscopic surgery. Minimally invasive skills, emphasizing two-handed technique and knot-tying, are developed in an inanimate skills lab and then applied during animal laboratory training. Approved fellowship programs are conducted in breast, cardiothoracic, pediatric, transplantation, vascular and minimally invasive surgery. Although exposure to a variety of patients is available, a balance between service and education is a program priority.

Conferences and Seminars

To augment the educational aspects of the program, each teaching hospital holds weekly conferences as well as other resident conferences and seminars and a wide variety of specialty conferences. Residents at each site may participate in many of these sessions via video conference.

Surgical residents must attend three weekly conferences: core curriculum, grand rounds, and mortality and morbidity. At the core curriculum conference, residents review and discuss topics based on the program's learning objectives. The morbidity and mortality conference, held in conjunction with core curriculum, permits residents and faculty members to discuss deaths and complications.

During their first year, residents attend a monthly conference that acquaints them with the basics of surgical patient care. They also complete a curriculum focusing on instruction in intravenous catheter, central line, and suturing skills, among others.

Research

The conduct of basic and clinical research is an important function of a university residency program. Residents may choose experience in laboratory, clinical, or educational research, which generally adds a minimum of one year to the program. The chair, program director, and resident determine the schedule and other arrangements for the research project.

Although residents currently evaluate their research experience quite positively, discussions are underway with faculty members on how to further enhance resident research experiences.

Hospital Experience

The program in general surgery uses the extensive educational resources of the McGaw Medical Center of Northwestern University, which includes the following hospitals.

Northwestern Memorial Hospital

The chief resident in surgery at Northwestern Memorial has a service of his or her own with appropriate attending staff supervision; special clinical surgery on this service includes complex and common breast, gastrointestinal, and oncology surgery and advanced laparoscopy. Residents rotate on the surgical critical care and trauma service under the direction of a faculty surgeon. In addition, another general surgical service is headed by a fourth-year resident who provides pre- and postoperative care and performs surgical procedures under the supervision of attending physicians. Residents also gain experience at Northwestern Memorial on the busy cardiothoracic, transplantation, and vascular services. Rotations are provided as well in anesthesiology; emergency medicine; and neurological, orthopaedic, otolaryngology—head and neck— plastic and reconstructive, and urologic surgery.

Jesse Brown VA Medical Center
The general surgical service, headed by the chief resident, admits and cares for patients under the supervision of attending faculty members. Instruction in endoscopy and laparoscopy is provided. Upper-gastrointestinal endoscopy, colonoscopy, and bronchoscopy are routinely performed by surgical residents. VA medical center provides a rich teaching experience for residents and medical students, with special emphasis on general, vascular, and thoracic surgery.

Ann & Robert H. Lurie Children's Hospital of Chicago

Residents in general surgery are assigned to the Ann & Robert H. Lurie Children's Hospital of Chicago, June 2012) for a three-month rotation during their second year. This hospital serves as the primary teaching facility for the medical school's pediatric and pediatric surgery programs. Medical students, surgical residents, and pediatric surgical fellows form teams to care for patients while supervised by an excellent attending staff. General surgical residents participate fully in rounds, conferences, operations, and patient care at Lurie Children's.

Outpatient Experience

Residents gain general surgery outpatient experience in hospital-based clinics at Lurie Children's, Northwestern Memorial, and Jesse Brown VA Medical Center, as well as in the private practice offices of faculty members. These outpatient facilities allow residents to participate in the initial evaluation, decision making, management, and follow-up of surgical patients. Residents are expected to spend two half-days each week in these outpatient settings, which also are available to them for evaluating and treating emergency or urgent surgical problems.

Resident Evaluations and Examinations

Attending staff members evaluate resident performance during each rotation. Twice each year, the Faculty Resident Evaluation Committee meets to provide a composite six-month evaluation. Residents meet with their assigned advisor to receive feedback, plan performance goals, and discuss the results of the evaluation. Residents take the in-training examination of the American Board of Surgery annually. In addition, an oral examination similar to the American Board of Surgery oral examination is given to residents in the final two years of the program. Additional performance-based exams provide further feedback to the residents and assess competency.

Positions Offered

First-year positions in general surgery are selected through the National Resident Matching Program. The department offers 5 positions to residents who wish to complete the five-year general surgery program and up to 10 positions to residents who want one or two years of general surgery experience before continuing subspecialty instruction elsewhere.

Interviews

Interviews are by invitation only. The resident selection committee reviews completed applications and sends letters stating whether an interview has been granted. Applicants may call the Office of Graduate Surgical Education at 312/926-2016 for additional information.

Department Chair

Nathanial J. Soper, MD
Loyal and Edith Davis Professor of Surgery

Program Director

Shari Meyerson, MD
Program Director, General Surgery

For more information, contact Residency Coordinator Leslie McSpadden, Department of Surgery, Northwestern University, Feinberg School of Medicine, 251 East Huron Street, Suite 3-150, Chicago, Illinois 60611-2908, 312/926-9404; fax 312/926-7404 or visit the Department of Surgery Web site.

E-mail: gensurg@nmh.org