Integrated vascular surgery residency
Core surgery rotations at UC Davis Medical Center
The rotation with the Department of Anesthesiology and Pain Medicine provides residents with an introduction to the principles of anesthesia and roles in perioperative management of patients undergoing major and minor procedures. Residents will be exposed to several anesthesiology specialties and types of care, including ambulatory anesthesia, cardiovascular and thoracic anesthesia, regional anesthesia, and trauma.
The UC Davis Burn Service provides care for adults and children who present with major burns. Over 500 acute burns are admitted per year. In addition, there is a very large affiliated plastic surgery and reconstructive program that provides additional care for these patients. Residents participate in ward, ICU, and operative care.
The Gastrointestinal (GI) Surgery service deals with all aspects of gastrointestinal disease and its surgical management. The GI Surgery service seeks to provide fundamental knowledge and experience for the resident in gastrointestinal physiology, including gastrointestinal endocrinology, critical care (as it relates to gastrointestinal surgical patients), and surgical nutrition.
Experience with evaluation, operative management (including minimally invasive surgical techniques) and follow-up care are included. Residents are expected to apply the principles of evidence-based clinical practice. Development of interpersonal and communication skills is emphasized for all residents at all times. The highest standards of professionalism are expected. The use of defined protocols or system-based practice will be used in those areas where sufficient volume has justified establishment of specific protocols. Examples include the surgical treatment of obesity and the provision of nutrition support.
The GI Surgery service offers an opportunity for residents to gain experience with the evaluation of acute and chronic abdominal pain, including patients who have known or suspected mesenteric ischemia. They will gain experience in the intraoperative evaluation of abdominal viscera. Even though laparoscopic surgical approaches are not generally considered standard techniques for aortic procedures, residents will gain sufficient experience with laparoscopic procedures to be able to use these minimally invasive techniques for diagnosis and basic interventions.
The after completion of the PGY-4 rotation, residents will be prepared to take the Fundamentals of Laparoscopic Surgery (FLS) examination.
Residents on the Neurological Surgery service will be introduced to the clinical and basic science related to the care of patients with neurological disorders or injury.
Residents rotating on the Orthopeadic Surgery Service will learn evaluation and management of musculoskeletal injuries and diseases, including spine, pelvis, and extremity problems. The rotation includes participation in common inpatient and outpatient surgical procedures.
The senior level rotation on Pediatric Surgery provides an opportunity to learn the differences between adults and children with surgical problems, to gain familiarity with congenital anomalies and genetic disorders associated with associated with vascular abnormalities, and to work in the clinical settings distinct to surgical care of children, infants, and neonates. Residents learn about the reasoning that enters into decisions for surgery in children. This will become evident in clinical encounters, such as the emergency room evaluation of a child abdominal pain where a decision for operation needs to be made.
The Plastic Surgery provides care for a variety of soft tissue management problems, including the management of basic and complex wounds, wounds in chronically ill or disabled patients, traumatic injuries (including facial fractures and hand injuries), and other challenges. The resident learns to evaluate and treat patients with plastic surgical problems.
The Surgical Oncology provides residents with education in the principles and rationale for performing cancer surgery, its basis in cancer biology, and the appropriate role of surgeons and of surgical treatment vis-à-vis other oncology disciplines. They will gain an understanding of the principles guiding evaluation of endocrine disorders, and the surgery for endocrine disorders.
Residents learn both curative and palliative management of the cancer patient. This includes attention to patient care, the employment of medical knowledge, and communication and interpersonal skills with regard to colleagues in other disciplines, and with patients in difficult social circumstances. Residents will learn about vascular complications of cancer therapy, principles of management when tumors involve major vessels, and the role of transcatheter procedures for cancer treatment.
UC Davis Division of Cardiothoracic Surgery provides clinical training in the diagnosis and surgical management of cardiac and thoracic diseases. Residents will rotate on the Thoracic Surgery service to gain experience with surgical management of a spectrum of conditions, including lung cancer, diseases of the pleura and chest wall, and a variety of diseases of the thoracic aorta, including acute aortic syndromes, aortic dissection, and traumatic injuries of the thoracic aorta.
Vascular Surgery residents will learn inpatient and outpatient care of thoracic surgery patients, experience intraoperative roles commensurate with the level of training, and they will receive instruction in the scientific basis of care and physiologic mechanisms. Residents function as members of a critical care team that involves ICU patient management, step-down unit patient care, and perioperative decision making. They will learn the basics of thoracic surgery and will develop surgical technical skills.
Transplantation Surgery Service
Residents on the Transplant Service will be to gain a better understanding of medical and surgical issues involved in the provision of care to patients who are candidates for or who have undergone intra-abdominal organ transplantation including kidney, liver, and pancreas allografts. Residents will also gain an understanding of surgical issues involved in organ donation. Further, they will care for patients with end stage renal disease in need of dialysis access. It is intended that by the completion of the senior rotation, residents will have a confident approach to the evaluation and management of patients referred for transplantation. In addition, they will have an understanding of the principles guiding evaluation of patients for dialysis access.
Trauma and Emergency Surgery
The Trauma and Emergency Surgery rotations teach the evaluation and management of patients with surgical disease that requires urgent and emergent care. UC Davis Medical Center is the region’s Level 1 trauma center, and the Trauma and Emergency Surgery service is busy, caring for patients with blunt and penetrating injuries. Much of the surgical management of traumatic vascular injuries at UC Davis Medical Center is done by the Trauma and Emergency Surgery service. Additionally, the service provides care for patients with many types of acute general surgery emergencies. The rotation offers experience with evaluation and management of the acute abdomen, complex soft tissue infections, biliary disease, and other conditions.
Building on their earlier experiences, residents at the PGY-2 level of training will work in the surgical intensive care unit (SICU).
At the senior resident (PGY-4) level, there will be additional emphasis on the provision of comprehensive, systems-based care and residents’ participation in surgical case will be greater.