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Goals
& Objectives
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General
Surgery Residency
Goals and objectives

| THE GUIDELINES FOR EACH LEVEL OF TRAINING BY SERVICE |
| Surgery Subspecialties |
| Surgical
Critical Care (PGY-2
and PGY-4) |
PGY-2
Level |
-
Understand
basic cardiovascular, pulmonary, and renal physiology.
-
Be
familiar with the terminology and calculations used in cardiac
profile analysis such as PCWP, SVR, CI, LVSWI, 02 availability,
02 consumption, 02 extraction ratio.
-
Begin
developing a knowledge of the various groups of pharmacologic
drips such as vasopressors, vasodilators, and inotropic agents.
-
Be
familiar with the basics of ventilation including vital
capacity, tidal volume, FI02, and mode (IMV, AC).
-
Define
PEEP and know its indications and side effects.
-
Define
and diagnose the various types of acute renal failure such as
nonoliguric, oliguric, and anuric renal failure.
-
Define
and diagnose hemorrhagic, oliguric, and anuric renal failure.
-
Define
and diagnose hemorrhagic, septic, and cardiogenic shock.
-
Define
and diagnose ARDS.
-
Be
familiar with the various groups of antibiotics including
aminoglycosides, penicillins, cephalosporins.
-
Be
able to calculate a patient's basal energy expenditure and
stress level and to formulate a nutrition program based on
these.
-
Be
familiar with the indicators of nutritional efficacy including
UUN, catabolic index, prealbumin, retinol binding protein,
transferrin.
- Understand the basic
advantages of parenteral and enteral nutritional support.
-
Be
familiar with the formulas used in enteral nutrition.
-
Become
comfortable with the techniques of PA catheter insertion, CVP
line insertion, arterial cannulation, intubation, and flexible
bronchoscopy.
-
Be
familiar with the principles of transfusion therapy including
indications, complications, and risks.
-
Be
able to present critical care patient data in an organized
fashion both on rounds and in the medical record.
|
Senior/PGY-4 |
-
Understand
advanced cardiovascular, pulmonary, renal, cerebral, and hepatic
physiology and apply this knowledge to patient care.
-
Interpret
data from cardiac profile analysis such as PCWP, SVO2, SVR, CI,
LVSWI, 02 availability, 02 consumption, 02
extrication ratio and make management these interpretations.
-
pharmacologic
drips such as Dopamine, Epinephrine, Levophed, Neosynephrine,
Nipride including dosages and effects.
-
Understand
current modes of ventilation including IMV, SIMV, AC pressure
control with inverse ratio, Pressure support, high frequency jet
ventilation.
-
Understand
the physiology of PEEP, its indications for use and its side
effects.
-
Define,
diagnose, and manage nonoliguric, oliguric, and anuric renal
failure.
-
Understand
the principles of hemodialysis and continuous arteriovenous
ultrafiltration and their application to patient care.
-
Define,
diagnose, and manage hemorrhagic, septic, and cardiogenic shock.
-
Define,
diagnose, and manage ARDS.
-
Be
familiar with the various groups of antibiotics including
Aminoglycosides, Penicillins, Cephalosporins; know their
indications, dosages, and side effects.
-
Be
able to construct a nutritional program consisting of
appropriate percentages of carbohydrate, protein, and lipid for
a critically injured patient based on BEE and stress level.
-
Be
able to constantly evaluate the efficacy of this program based
on changes in UUN, catabolic, index, and levels of prealbumin,
retinol binding protien, and transferrin.
-
Understand
the importance of carbohydrate, protein including high branched
chain amino acids, and lipid to the nutrition program.
-
Understand
the advantages and disadvantages of parenteral and enteral
nutrition.
-
Understand
the composition of the most frequently used formulas in enteral
nutrition.
-
Supervise
the junior residents in the techniques of PA catheter insertion,
CVP line insertion, arterial cannulation, intubation, and
flexible bronchoscopy.
-
Understand
the principles of transfusion therapy including the indications
for transfusion, the complications, and the risks including AIDS
and hepatitis.
-
Be
familiar with the criteria for brain death and the criteria for
organ procurement.
- Be
able to present critical care patient data in an organized
fashion both on rounds and in the medical record.
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Urology (PGY-1) |
-
Obtain an adequate urologic history.
-
Perform an adequate physical examination upon the
genitourinary system - i.e. abdomen, pelvic exam in females, male
external genitalia and prostate.
-
Recognize common significant abnormalities in IV
urogram,
renal sonogram and abdominal CT Scan.
-
Diagnose and manage renal colic, cystitis,
prostatitis, epididymitis.
-
Perform minor urologic surgery such as circumcisions, remove
condylomata biopsies.
-
Know
the steps necessary to evaluate patients with UTI, hematuria and
calculi.
-
Perform
routine catheterizations and urethral dilations.
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| Cardiothoracic
Surgery (PGY-,
2) |
PGY-2
Level
This rotation is two months in duration in the CT/SICU. At the PGY-2 level,
residents are expected to have evolved their clinical abilities
beyond the requirements of entry level resident in his program. In
addition they are given graded responsibility for the surgical
management of uncomplicated conditions such as pulmonary nodules. At
this level the residents are introduced to surgical principles and
technique in performing thoracotomies. They also learn the basics of
pulmonary resection, vascular surgery and esophageal surgery. |
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