The major clinical site, Hahnemann University Hospital (HUH), is a 619-bed tertiary care facility, located in Center City Philadelphia. Operated by Tenet Health, it is home to the region’s first Level One Trauma Center and serves as a major referral center for heart disease, cancer, trauma, orthopedics and other specialty areas. More than 17,000 patients are admitted annually, and another 100,000 are treated as outpatients. As an inner city facility, Hahnemann University Hospital provides care for many uninsured and underinsured patients, as well as those individuals with adequate health insurance. The Department of Surgery at Hahnemann is among the most prolific in Philadelphia. The site of the city’s first kidney transplant, Hahnemann currently ranks second in transplant surgeries in the Delaware Valley. Major surgery services constitute a comprehensive surgical residency experience that includes:
- Oncologic surgery
- Vascular surgery
- Hepatobiliary surgery
- Colorectal surgery
- Transplant surgery
- Trauma surgery
- Bariatric surgery
- Laparoscopic surgery
- Orthopedic surgery
- Genito-urinary surgery
- Plastic surgery
- Cardiothoracic surgery
Hahnemann is also the home of a DaVinci robotic surgical system, which provides the flexibility of open surgery while operating through tiny ports.
The overall objectives of the general surgery rotation at St. Christopher’s Hospital for Children are designed to facilitate ample exposure to the comprehensive care of the pediatric surgical patient. As a broad-based specialty, the rotation provides experience in the fundamental components common to all surgical disciplines, including:
- Anatomic malformations
- Inflammatory conditions requiring operative intervention
- Traumatic injuries
- Benign and malignant neoplasms
- Critical care
The educational agenda during the rotation at St. Christopher’s Hospital for Children emphasizes:
- Direct patient contact in both the inpatient and outpatient settings
- One-on-one discussions of these patients with the attending physicians
- Formal teaching rounds
- Supervised operating room experiences
- Formal didactic conferences
Individualized clinical experiences are further enhanced through:
- Focused patient care, from initial preoperative evaluation through postoperative follow-up
- Didactic knowledge pertaining to pediatric surgical processes
- Communication skills, emphasizing the unique needs of children and parents
- Evaluation of the non-verbal child
- Development of appropriate professional behavior with children, families clinical and administrative staff
- Recognition of the role of the pediatric surgical specialist regarding referrals for appropriate complex problems
This educational experience for junior residents (PGY1) provides education on pediatric surgery for a period of two months. During this time, they are assigned patients whom they closely follow and care for under the supervision of fellows and faculty. This format facilitates an assimilation of knowledge through direct patient care and professional interaction. Residents become familiar with and comfortable conducting physical examinations and evaluations of the pediatric patient and communicating with families and co-workers. Organizational skills are further enhanced through the execution of management plans and the preparation of written orders for care including the administration of fluids, nutrition, and antibiotics. Junior residents are supervised by ongoing instruction and feedback, thereby ensuring patient safety and maximal learning. During more simple cases, junior residents have an opportunity to augment their basic operative skills by participating in the operating room.
The pediatric surgery service includes a broad spectrum of cases, including:
- Gastrointestinal surgeries of all types
- Non-cardiac surgeries of the chest
- Endocrine surgeries
- Transplant surgeries
- Trauma surgeries
Cases are distributed among the pediatric surgery fellows, senior and junior residents, based on the level of complexity. During a five week rotation period, PGY1 year residents complete 20 cases including:
- Soft tissue mass surgeries
PGY2 residents rotate at this institution for the care of burn-injured patients. Clinical training takes junior level residents from emergency treatment through intensive care and rehabilitation to follow-up and outpatient management. This challenging five week rotation incorporates:
- Initial care (including fluid resuscitation)
- Wound management (with an emphasis on surgical infection)
- Smoke inhalation and smoke-related pulmonary issues
- Advanced surgical nutrition
- Early reconstructive measures
Junior level residents develop sound clinical skills pertaining to:
- The extent and severity of burn-induced wound(s), including methodologies for estimating body surface injury.
- Determination of method for wound management including classical topical therapy as well as advanced synthetic and bioengineered wound closure systems.
- Diagnosis and management of wound infection with an emphasis on sepsis.
- Diagnosis and management of smoke inhalation and inhalation-induced ALI and ARDS with an emphasis on management of ventilator-dependent surgical patients.
- Surgical nutrition, as it pertains to extreme needs of thermally injured patients.
Residents also respond to burn wounds in the emergency department and participate in the outpatient burn wound care center, which operates four (4) days per week.
The goal of the Aria Health rotation is to provide residents with an opportunity to gain experience at a second community facility and private practice. Three residents rotating there include PGY2s for 5-6 weeks, the PGY3s for 2 months and the PGY4s for 2 months. These residents acquire a wealth of experience facilitated by participating in:
- Inpatient, outpatient and office procedures
- Formal teaching rounds
- Supervised operative procedures
- Formal clinical conferences
Residents rotating at Aria Health engage in a wealth of supervised surgical procedures, including:
- Inguinal and abdominal hernia repairs
- Laparoscopic cholecystecomies
- Small and large bowel resections
- Sentinel lymph node biopsies
- Axillary lymph node dissection
- Common peripheral and vascular surgery procedures
- Non-cardiac thoracic cases
- Robotic surgery
This is our integrated institution and is our second primary teaching institution. Founded in 1907, Saint Peter’s University Hospital (SPUH) is a 422-bed teaching hospital in New Brunswick, New Jersey. More than 30,000 inpatients and more than 200,000 outpatients are treated at SPUH annually. Surgeries include:
- General and non-cardiac thoracic surgeries
- Advanced minimally invasive procedures, including VATS
- Plastic surgeries
- Head and neck surgeries
- Endocrine surgeries
- Alimentary surgeries
- Pediatric surgeries
There are currently 7 residents at Saint Peter’s University Hospital at a time. There are two PGY1, one PGY2, one PGY3, two PGY4 and one PGY5 residents who all rotate two months a year, except for the PGY2 residents, who rotate for a total of 5-6 weeks. Residents are supervised by those attending physicians who are members of the teaching staff, in accordance with the goals and objectives of their respective surgical disciplines. SPUH has efficient, state-of-the-art laboratory, pathology and radiologic resources.
The PGY3 residents do an ambulatory rotation at at the Center for Colon and Rectal Health in Langhorne, PA, which is five days a week in the outpatient clinic for endoscopic requirements. This rotation offers residents the opportunity to learn more about proctology, anorectal physiology and endorectal ultrasound.