Cooperstown, New York
Bassett Medical Center has had a long tradition of commitment to medical education and surgery training has been a part of that commitment for over 50 years. The program recently expanded from 2 to 3 residents per year and will finish its first class of three Chief Residents in 2013. The program offers a broad range of surgical experience not found in most university programs. Because there are no competing subspecialty residencies, the residents have greater depth and breadth of exposure to a whole host of surgical subspecialty diseases and operative management. The residents live and train in a small town, which provides unique experiences and opportunities.
The program is a major teaching hospital of Columbia University and is now a medical school clinical campus with the Columbia-Bassett campus now open. Since there are no competing specialty residencies, residents care directly for patients in the fields of neurosurgery, orthopedic surgery, urology, plastic surgery, cardiothoracic surgery, and otolaryngology head and neck surgery. For residents planning a career in rural areas, electives exist for increased experience in surgical specialties as well as rural rotations.
Half of the graduates of the program enter general surgery practice.
David C. Borgstrom, M.D.
Bassett Medical Center
One Atwell Road
Cooperstown, NY 13326
East Carolina University
Greenville, North Carolina
The surgical residency at East Carolina University is sponsored by Vidant Medical Center. Vidant Medical Center meets the extensive health care needs of coastal North Carolina, serving over 100,000 local citizens in addition to being the only tertiary referral center in eastern North Carolina. The East Carolina University School of Medicine has grown rapidly in size and stature under joint sustained public, private, and governmental support. The residency produces “toti-potential” general surgeons. The graduates are competitively prepared for fellowships, academic positions, and private practice. There are five categorical residents in each year of the residency. One year of the residency is devoted to research.
The residency program includes a required one month rural surgery rotation in the PGY-4 year. This rotation occurs in Edenton NC which is about 2 hrs from Greenville and about 1 hour from the cost. Edenton is a small community on the Pamlico sound which is supported by a Vidant Medical system hospital. This hospital has surgical capabilities with three operating rooms, a small 4 bed ICU and a 10 bed emergency department. Residents stay in a local apartment when rotating and join a busy three member general surgical practice. They participate in clinical hospital and office care, operative management and consultations. The experience enhances understanding of “bread-and- butter” general surgery, private practice setting, global patient care as well as the limited resources of non-tertiary referral centers. The residents value and enjoy the experience; some choose to return for elective time.
Claudia Goettler, M.D.
Program Director Department of Surgery, East Carolina University
600 Moye Blvd. Greenville, NC 27834
East Tennessee State University
Johnson City, Tennessee
The ETSU Department of Surgery Residency Program at the Quillen College of Medicine prides itself on helping high quality individuals develop into skilled surgical practitioners. The Department believes that there is need for "old school" general surgeons who have the ability to provide a wide variety of a solid knowledge base and a technical skill set that allows our residents to enter a diverse practice immediately upon completion of their residency. While many residents do decide to undertake fellowship training, we do not want our general surgery training to simply prepare someone for fellowship. We expect our graduates to be well-situated and ready for practice upon completion of their training.
Our program operates out of three health care systems and four hospitals. Each of these facilities provides unique and diverse educational opportunities. The Johnson City Medical Center is a 488-bed tertiary referral hospital. It is a flagship hospital for Mountain State Health Alliance - a thirteen hospital comprehensive health care
system. The 114-bed Quillen Veteran's Affairs hospital provides excellence general surgery experience for our residents. Wellmont Health Systems is an eight-hospital system from which we use Holston Valley Hospital (505 beds) and Bristol Regional Medical Center (348 beds) to train our residents. Residents work with a wide variety of faculty, from highly specialized individuals to those who practice a wide variety of general and vascular surgery. Rotations offer experience with University groups and private groups, allowing residents significant exposure to a wide variety of practice types. An optional year after the 3rd or 4th year of residency is available to residents wishing to prepare for rural community practice; the year involves in depth experience in orthopedics, urology, ENT, and gynecological surgery.
In recent years, approximately half of our graduates have entered the practice of general surgery and have gone on to additional training. Our residents have obtained competitive fellowships in cardiothoracic, minimally invasive, colon-rectal, trauma/critical care, plastics, breast, endocrine, and vascular surgery. Additionally, our residents who are interested in research have the opportunity to work in a well-funded department with six full-time faculty and multiple post-docs.
Our residency is always trying to identify and attract high value individuals who care for their patients. We provide excellent educational opportunities across a wide spectrum of general surgery practice, and we train general surgeons in a manner that equips each graduate to provide the highest possible care for his/her patients.
William Browder, M.D., M.S.H.A.
Professor and Residency Program Director, East Tennessee State University Department of Surgery
Dogwood Ave. Bldg. #1, Room 2-52, Johnson City, TN 37614
Ten Rural-Focused Residency Programs
Descriptions and contact information for ten programs highly recommended for future rural surgeons
Gundersen Lutheran Health System
The Gundersen Lutheran Health System represents a multispecialty group practice with a 19-county referral area. This program has long been a mainstay in the surgical training of residents who largely pursue careers in rural settings. Among the 52 graduates of the five-year surgical residency program since it began in 1974, 40 percent elected to practice in towns with a population of less than 15,000. Currently, 49/52 graduates (3 awaiting exams) have earned American Board of Surgery certification.
Because the only surgical specialty to sponsor a residency at Gundersen Lutheran (GL) is general surgery, residents are prepared for a full general surgical practice as well as competitive fellowships. Surgical residents work with attending staff in the surgical specialties-including orthopaedics, neurosurgery, otolaryngology, burn surgery, plastic surgery, cardiothoracic surgery, and urology-in a one-on-one training setting when assigned to these sections. In addition, residents perform 25 cesarean sections and 20 hysterectomies, plus gynecologic oncology cases, over two months during the third year of residency.
Residents complete a high-volume endoscopy rotation over two months which leads to the completion of more than 150 colonoscopies and 50 upper gastrointestinal endoscopic procedures.
The PGY V residents at GL lead the Chief Resident Surgery Service where they are in charge of their own patients with dedicated outpatient and protected operative time to facilitate their transition into clinical practice. The chief residents are in charge of all aspects of patient care during this experience to include patient selection, preoperative evaluation and testing, operative management and post-operative care. Patient continuity is afforded through this opportunity. In addition, the chief year can be adjusted to facilitate exposure to anticipated practice patterns (endoscopy, C-sections, etc) following graduation.
Elective rotations in rural surgery are available at regional sites with populations of less than 8,000-during the third or fourth postgraduate year. The residents who pursue these rural surgery experiences live in the community they serve and take call with the attending surgeons at the local hospitals. These residents assume responsibility for the care of all surgical patients-including nutrition and critical care needs. In addition, for those residents who have already decided to pursue a rural surgical career and know where they want to practice, the program has made arrangements for electives to be performed at the chosen institutions.
Additional elective opportunities which prepare surgery residents for rural opportunities include an international rotation and opportunities through the GL Global Health Initiative which is working to provide sustainable relationships with underserved populations in Tanzania, Nicaragua and the Pine Ridge Indian Reservation in South Dakota.
For further information, please contact:
Benjamin Jarman, M.D.
Gundersen Lutheran Medical Foundation
1836 South Avenue, Mail Stop C05-001, La Crosse, WI 54601
University of Nebraska Medical Center
Since its founding in 1869, The University of Nebraska Medical Center (UNMC) has served as an academic center of excellence. UNMC is the mother institution of one of the region’s premier general surgery residency program. The program provides the residents with exposure to a diverse spectrum of practice settings. These include academic tertiary care, Veterans Affairs, large private practice, small private practice, international rotations and rural settings. These diverse rotations provide the residents with the exposure needed to choose a career path of their choice.
The rural rotation is undertaken at the Great Plains Regional Medical Center (GPRMC) in North Platte, Nebraska. North Platte is approximately 270 miles from Omaha and is a leisurely 4 hour drive. Accommodation is provided for our residents.
The GPRMC is a busy rural based hospital with 116 beds, 10 operating rooms and an annual case volume of 8000 operative cases. The hospital is in a growth phase with plans for expansion. The GPRMC is a regional hub and caters to wide underserved areas with satellite clinics in many locations.
The Surgery group at the GPRMC consists of four surgeons and the practice includes the entire spectrum of simple/complex open and minimally invasive general surgery cases with extensive endoscopy volumes. The endoscopy (upper and lower) experience includes both diagnostic and therapeutic endoscopy with an annual average volume of approximately 800 cases. As there is no gastroenterology service in the area, the surgeons are responsible for the endoscopy needs.
A rural rotation of one month in PGY III was started last year and has been received well with an approximate case volume greater than 80-100 cases. There are plans afoot to expand this rotation based on the feedback we received till now.
The several benefits of this rural rotation include:
allows residents to experience the life of the rural surgeon.
provides residents with exposure to practice in a rural setting
provides exposure to the entire spectrum of general surgery in a small town setting
provides enhanced endoscopy experience with both diagnostic and therapeutic endoscopy
provides exposure to billing, coding practices in a private setting
Chandrakanth Are, M.D.
University of Nebraska Medical Center
984030 Nebraska Medical Center, Omaha, NE 68198
Phone: 402 559 firstname.lastname@example.org
University of North Dakota
Grand Forks, North Dakota
The rural surgery tract of the University of North Dakota General Surgery Residency Program is designed to better prepare general surgeons who wish to practice in rural environments.
The University of North Dakota General Surgical Residency Program has a long history of preparing residents for practice in rural environments. In fact, the UND surgical residency program has a higher percentage of graduates practicing in rural areas than most other programs in the country. Over 40% of former graduates of the UND general surgical residency program currently practice in rural environments.
Based on its long history of training for rural surgery practices and the current involvement in major rural surgical initiatives, the University of North Dakota surgical residency program has designed a rural surgery tract to recognize and better train residents who wish to practice in rural environments.
Program Description:The rural surgery tract involves nine months of training in surgical subspecialty and rural surgery rotations in the PGY 2, 3, and 4 years. A representative example of the rotations is shown below. Six of the nine months are dedicated to subspecialty rotations that are common subspecialties in which rural general surgeons often perform cases. The subspecialty rotations are designed to allow the rural general surgeon to be familiar with and competent in the basic procedures in these subspecialty areas. In addition, rural surgery residents will have a better perspective on the types of subspecialty cases that can be safely performed in their local institution and be better able to decide when it is best to refer patients for subspecialty care. The management of emergency situations in these subspecialties is also stressed. The PGY-1 and PGY-5 years of residents in the rural surgery tract are the same as the general surgery tract residents. All ACGME Surgery Residency Review Committee and American Board of Surgery requirements are fulfilled with the rural surgery tract rotation schedule.
The UND Department of Surgery has two categorical tracts listed through the Electronic Residency Application Service (ERAS) and National Residency Matching Program (NRMP). One tract is for categorical general surgery which has two positions and the other tract is for categorical rural surgery also with two positions. Applicants may apply to one or both of the tracts. Applicants who are interested in a rural surgery tract should contact the Department of Surgery at the University of North Dakota School of Medicine and Health Sciences for additional information.
Robert P. Sticca, M.D., FACS
501 North Columbia Road
Grand Forks, North Dakota 58203
Oregon Health & Science University
The general surgery residency at Oregon Health & Science University is a large academic program with twelve categorical residents per year. The program strives to train surgeons who have the expertise and confidence to directly enter into general surgery practice or to be competitive for the finest fellowship programs. A rural year is available for two categorical residents in lieu of their usual research year following the third clinical year of training. The experience counts for the fourth clinical year. Residents spend an entire year in Grants Pass, Oregon, a town of 34,533 located 3.5 hours south of Portland on Interstate 5. The hospital at Grants Pass is a well-equipped, modern 125-bed general hospital. The surgical staff includes a large group of Board-certified general surgeons and also Board-certified obstetric-gynecologists, orthopedic surgeons, otolaryngologists, and a urologist. There are no specialty residents to compete with general surgery residents for specialty experience. There is also a rich experience in endoscopy. The site includes its own M&M, Journal Club, and county medical society meetings. The two general surgical residents become integral parts of the office practice of the general surgery group and of the small community of Grants Pass. Resident Conferences held at OHSU are videotaped and residents in Grants Pass are sent a link to the video for viewing at their convenience. Residents perform 300 to 500 cases during their year in Grants Pass and return from their rural experience to become chief residents at Oregon Health & Science University.
Karen Deveney, M.D., Program Director
Robin Alton, Education Manager
OHSU Department of Surgery
3181 SW Sam Jackson Park Road
Portland, OR 97239
University of Tennessee Medical Center
The general surgery program has four categorical positions each year. The Department of Surgery’s educational mission is to prepare young surgeons for leadership positions in both community and academic practice.
The rural experience includes a one-month elective at the PGY-3 level in a rural or international setting and a three-month rotation at the PGY-4 level in a rural hospital.
Rotations at the University include a one-month gynecology experience and experience managing fractures, dislocations, hand injuries, and other non-operative orthopedic and neurosurgical problems since there is a Level 1 trauma center but no residency programs in orthopedics or neurosurgery.
Over the past 15 years 55 residents have graduated from the program and 23 are practicing in a rural setting.
Brian J. Daley, M.D.
Department of Surgery, Box U-11
1924 Alcoa Highway Knoxville, TN 37920
University of Tennessee Chattanooga
The University of Tennessee College of Medicine-Chattanooga General Surgery Residency Program is a six year program consisting of five years in clinical training and one year in clinical research. Five categorical surgery positions are available each year. Residents completing this program are truly “general surgeons” in that the program provides a broad clinical experience enabling graduates to successfully enter surgical practice or a nationally recognized fellowship. The majority of clinical training takes place within the main Erlanger campus. This training is comprehensive, encompassing all areas of general surgery and related subspecialties. Surgery residents are involved in door-to-door care of approximately ninety percent of all patients admitted to the general surgery, thoracic, and vascular surgery services.
The program also provides a rotation in rural general surgery. Each PGY-3 level resident spends three consecutive months in the rural towns of Athens and Etowah, Tennessee. Athens and Etowah are located within an hour from Chattanooga and have a combined population of 17,000. Each resident works one-on-one with three faculty members who are graduates of the University of Tennessee Chattanooga. This rotation offers residents a true private practice experience featuring the full breadth of general surgery and endoscopy numbers in the 90th percentile nationally. Housing is provided but the resident may commute when not on-call.
Joseph B. Cofer, M.D., Program Director
W. Heath Giles, M.D., Associate Program Director
c/o Cindy Rudolph, MS
960 East Third Street, Suite 104, Chattanooga, TN 37403
University of Utah
Salt Lake City, Utah
The University of Utah General Surgery Residency Program has designed a rural health experience to better prepare residents for rural practice by enhancing their skill set in areas that are not usually part of the traditional general surgery residency program. This experience is a one year program based at Ogden Regional Medical Center, north of Salt Lake City. It includes non-traditional rotations such as obstetrics-gynecology and orthopedic surgery. It also includes a two month experience at a rural hospital. This additional year substitutes for the laboratory year that is a normal part of the general surgery residency. It also has a research component with residents expected to prepare a research paper during this year.
For additional information about this program, please contact:
Lori Bybee, Program Coordinator University of Utah
3B-110, Dept of Surgery
30 North 1900 East
Salt Lake City, UT 84132