The general surgery residency is a five-year program encompassing all aspects of general surgery as well as the surgical specialities, with an optional year of basic research available. The general surgical subspecialties include endocrine surgery, gastrointestinal surgery, surgical oncology, vascular surgery, advanced laparoscopic surgery, surgical ICU, and trauma surgery. Residents are also assigned to other surgical services with approved graduate education programs including orthopaedic surgery and urology. Five categorical residency and 15 preliminary internship positions are made available each year.
PGY1: Assignments during this year are for one-month periods, providing exposure to general and speciality services in the two affiliated hospitals. The resident will gain experience through one-month assignments to general surgery and the surgical specialities including anesthesia, cardiothoracic surgery, transplantation, vascular surgery, orthopaedic surgery, pediatric surgery, plastic surgery, and urology. Emphasis is directed to the fundamentals of both preoperative and postoperative surgical care and to learning fundamental technical skills.
PGY2: Assignments in this year are for two- or three-month periods, focusing on pediatric surgery, trauma, cardiothoracic, vascular surgery, and breast / endocrine surgery.
PGY3: Assignments are three months long in the third year. Assignments include the transplant, vascular, night emergency / trauma, and gastrointestinal surgery services as well as the general surgery service at the Veteran's Administration and cardiothoracic surgery.
PGY4: During this year, residents serve as senior general surgical residents on the daytime and nightime trauma / emergency surgery service, breast / endocrine surgery, and the pediatric surgery service. Another rotation is with a group of well-respected general surgeons at a community hospital.
PGY5: Chief residents are assigned to four surgery services. These are the liver / biliary and laparoscopic surgery, gastrointestinal, oncology and vascular surgery services at the Medical University Hospital, and general surgery at the Ralph H. Johnson Veterans Administration Medical Center. The chief resident is expected to assume maximum responsibility for all aspects of surgical care on each service.
Night call for most services is covered by the Night Emergency / Trauma (NET) Service. Residents may be on backup call every third or fourth evening, but this schedule may vary according to the assigned rotation. Work schedules are established so that residents work less than 80 hours per week with one day in seven "off", ten hours off between duty shifts, and a maximum of 24 hours on call.
Residents have the opportunity to take a two year period away from clinical rotations to participate in full-time laboratory research in one of several areas of surgery, including oncology, transplantation immunology, and cardiovascular surgery.
Throughout the program, there are regularly scheduled conferences. On a weekly basis, the surgical service conference reviews all morbidity and mortality cases. A weekly basic science and clinical seminar series reviews a core curriculum in fundamental problems relevant to surgical care. Presentations are given by members of the surgical staff, faculty from other clinical and basic science departments, and senior surgical house officers. Surgical grand rounds are held weekly and include presentations from all aspects of general surgery such as vascular, endocrine, trauma and gastrointestinal surgery, as well as the surgical subspecialties. In each hospital, surgical clinics are held weekly for follow-up of patients cared for on the general surgical services. Attendance at clinics is required of all surgical residents. A weekly cancer clinic also is held. Residents make presentations at weekly conferences attended by both residents and students. Each resident takes the annual in-service examination of the American Board of Surgery. Upper-level residents also are given oral examinations which closely approximate the conditions and content of the certifying examination of the American Board of Surgery. Those residents choosing to pursue further training have also done well, with all such graduates over the last ten years serving fellowship spots in their chosen specialties.
Prabhakar Baliga, MD
Professor of Surgery
Chair, Department of Surgery
|E. Douglas Norcross, MD|
Professor of Surgery
Vice-Chair of Education
Christian Streck, Jr. MD
Associate Professor of Surgery and Pediatrics
Program Director, General Surgery Residency Program
Andrea Abbott, MD, MS
Assistant Professor of Surgery
Associate Program Director, Simulation Center Curriculum
Aaron P. Lesher, MD
Assistant Professor of Surgery and Pediatrics
Associate Program Director - Basic Science Curriculum
Denise Carneiro-Pla, MD
Associate Professor of Surgery
Associate Program Director - Research Curriculum
Director of Education
Resident Coordinator, General Surgery Residency Program
General Surgery Conferences
|Conference||Frequency / Length||Person(s) Responsible for Conference|
|Department of Surgery Grand Rounds||2nd Tuesday of each month / 1 hour||Vice-Chair of Education / Division Chiefs|
|Morbidity & Mortality Conf||Weekly / 1 hour||Drs. Robert Cina, Rana Pullatt, and Mark Lockett|
|Combined Basic Science||Weekly / 1 hour||Aaron P. Lesher, MD|
|Junior Journal Club|
|5 per year / 2 hour||Charleston Journal Club|
|Senior Journal Club|
|5 per year / 2 hour||Charleston Journal Club|
The Basic Science Course is intended to provide an introduction to within general surgery, with all essential topics covered at least every third year, and the most critical topics presented annually. The conferences are held weekly from July through May on Tuesday mornings from 8:00-9:00am in Room 300 CSB for all PGY levels. Residents are excused from clinical duties on all services (including the operating room) during this time except for emergency care of patients. Designated preliminary (ortho, urology, ENT, ophtho, neurosurgery) are not required to attend. The schedules of conference topics and presenters are distributed annually and available on the website. Residents are expected to prepare in advance for the weekly conference by reading the appropriate reading assignment as noted on the conference schedule.
Department of Surgery Grand Rounds are scheduled the second Tuesday of every month (July-June) at 7am in Room DD110, Drug Discovery Building. These grand rounds are mandatory for all surgical faculty, house officers and students on service. Attendance records are maintained in the Department. Selected residents will participate on a regular basis in the grand rounds presentation and will, on occasion, be responsible for the entire grand rounds.
Morbidity and Mortality Conference:
Morbidity and Mortality Conference is held every Tuesday at 7:00 a.m. in 2-West Amphitheater (except on the 2nd Tuesday of the month when the Department of Surgery Grand Rounds takes place of the M&M Conference). Attendance is mandatory for all surgical housestaff, students and attendings. Attendance records are maintained in the Department. The service reports are reviewed from the previous week and all complications and deaths are presented and discussed in detail by the resident responsible for that service or performing the procedure. The responsible resident is expected to have all pertinent x-rays, operative photographs, and/or pathology specimens available for this conference and to be prepared to discuss their cases in depth having prepared themselves by a thorough review of the pertinent literature.
Surgical Journal Club is held from August through May, alternating months between the PGY1/2 Junior Journal Club and the PGY3-5 Senior Journal Club. These are tentatively planned to be held on the 3rd Tuesday of the month at 6pm when possible. The Development Office is coordinating with the local Charleston Journal Club and selected outside medical sponsors. The research resident(s) will select the articles to be discussed and these will be submitted to the Charleston Journal Club for selection by that month’s sponsor.
The General Surgery Residency Program requires 5 years of training with an option of two additional years of research training.
PGY-1 assignments are primarily for one-month periods and include broad exposure to general and specialty services in the two primary affiliated hospitals (ART and Main) and the VA. Upon completion of the year, the Resident has had experience in each of the hospitals and exposure to most of the full time staff. Emphasis is directed to the fundamentals of surgical care, preoperative and postoperative, as well as learning fundamental technical skills.
PGY-2 assignments are for roughly 2 months and afford experience in general surgery, breast/endocrine, pediatric surgery, critical care, endoscopy and trauma.
PGY-3 assignments are for periods of typically 2 months and include assignments in night emergency/trauma surgery, transplant surgery, VA General Surgery, Surgical ICU, GI surgery and Trauma.
PGY-4 residents serve as senior general surgical residents on night trauma, trauma surgery, vascular surgery, pediatric surgery and Thoracic Surgery. The resident also has a rotation at the McLeod Regional Medical Center in Florence, SC where experience in general surgery in a private practice community hospital is acquired.
PGY-5 Chief Residents are assigned full time to general surgery services including - Laparoscopic/Bariatric GI, Biliary/Pancreas, and Surgical Oncology at the ART;
General/Vascular Surgery at the VA and Night Emergency Trauma. The Chief Resident is expected to assume maximum responsibility for all aspects of surgical care on each service.
Assignments are intended to provide a broad base of experience in the first two years and increasing responsibility for surgical care throughout the final three years, culminating in maximal opportunity to manage surgical patients in and out of the operating room in the year as chief resident. The number of months spent on each rotation and sequence will vary based on the number of Residents in each PGY class impacted by research lab matriculation.
Night Float (ART)
Surgical Trauma ICU
VA General Surgery
Pediatric Surgery (2)
Surgical Oncology (2)
Night Emergency Trauma (2)
Surgical Trauma ICU (2)
CT ICU (1)/ Vascular Access (1)
Community Surgery in Florence, SC (1)/ Endoscopy (1)
Kidney/Pancreas Transplant Surgery (2)
GI Laparoscopy (2)
Pancreatic/Biliary Surgery (2)
VA General Surgery (2)
Pediatric Surgery (2)
Community Surgery in Florence, SC (2)
Trauma (1)/Night Emergency Trauma (1)
Thoracic Surgery (2)
Liver Transplant (1)/Elective (1)
Vascular Surgery (2)
VA General Surgery
Trauma (1)/Night Emergency Trauma (1)
Residents acquire an understanding of the principles of General, Trauma, Vascular, Pediatric, and Transplant Surgery as well as Surgical Critical Care and endoscopy during their Residency. During their clinical experience these Residents function at a level of responsibility commensurate with their level of training and achieve clinical educational milestones defined in the Goals and Objectives outlined for each rotation.
Residents receive extensive training in the full spectrum of general surgery including complex laparoscopy, pancreatobiliary surgery, and tumor surgery while rotating on numerous general surgery services. All services are staffed by residents as there are no fellows. Residents can expect to be participatory in all operations. The GI/Laparoscopic service typically performs 10-15 complex laparoscopic and bariatric procedures per week to include but not limited to gastric bypass/sleeve gastrectomy/duodenal switch, laparoscopic gastric and colorectal resections, and laparoscopic hernia repair. While on the GI/Pan-creatobiliary service, the residents participate in 5-10 cases per week that consist of major pancreatic resections, operations for acute and chronic pancreatitis, and major biliary reconstructions. The surgical oncology service cares for patients with breast, soft tissue, and gastrointestinal malignancies with a case load of approximately 15 cases per week which includes breast biopsy/mastectomy/sentinel node biopsy and axillary dissection, major liver and pancreatic resections, and soft tissue sarcoma resections.
The Trauma Service covers all trauma and acute care surgery at MUSC
Medical Center. It is a high volume complex service that performs 10-15 operations per week with a split between operative trauma and acute care surgery. Common acute care surgery cases include laparoscopic appendectomy, Hartmann’s procedure for diverticulitis, and exploratory laparotomy for bowel obstruction. The operations for trauma are chest and abdominal exploration for both blunt and penetrating trauma. In addition, there is roughly one ER thoracotomy per month. Again, the general surgery resident is fully participatory in our Level 1 trauma center as there is a critical care fellow but no trauma fellow.
Residents at the PGY 1, 2, and 4 levels are assigned to Pediatric Surgery. The PGY 1 rotation is for one month, while the PGY 2 and PGY 4 rotations range from 2-3 months each at MUH (the Main hospital). The PGY 4 serves as the acting chief for this service. Resident responsibilities include care of inpatients, attendance in the main and ambulatory operating rooms, and attendance at the weekly outpatient clinic, all under the direct supervision of the Pediatric Surgery attending staff. This is one of the busiest operative services with each Resident (PGY 2 and PGY 4) performing 10-15 cases per week. The PGY 4 General Surgery Resident scrubs on all major neonatal cases as there are no Pediatric Surgery fellows.
PGY 1, 3 (kidney/pancreas/vascular access), and 4 (liver) residents are assigned to Transplant Surgery at MUH for 1-2 months. The PGY 3 or PGY 4 resident always serves as the acting chief for this service. Residents are involved in preoperative care of outpatients and in the operative and post-operative care of inpatients. Residents are also given the opportunity of traveling to outside hospitals for organ recovery when appropriate. Residents at the PGY 2 and 3 levels from four other general surgery programs rotate from 1 to 2 months on Transplant Surgery due to the patient volume and attending staff expertise.
During the fourth year, residents rotate for two months in Florence, South Carolina to assume an apprenticeship under a busy community general surgery practice based at McLeod Regional Medical Center. The resident assumes a junior partner role in the practice and evaluates all patients preoperatively and postoperatively in the clinic. Cases are performed by the resident with assistance of a senior partner in the practice. The practice covers the full spectrum of general surgery ranging from lipoma to colon cancer. Residents can expect to approximately 10-15 cases per week including breast cancer management, common general surgical problems such as gallbladder disease, and major operations including laparoscopic
All residents are under the direct supervision of the Thoracic Surgery attending faculty. They attend and participate in Thoracic Surgery clinics, conferences, special lectures, and have clinical responsibilities for patient in the operating room as well as on the wards and in the CTICU. PGY1 residents rotate for one month on Cardiothoracic Surgery at MUH. Their primary inpatient responsibilities involve providing pre- and postoperative care for patients admitted to the nursing unit. PGY-4 Residents have exposure to a wide variety of complex thoracic procedures and act as the Chief Resident for 1-2 months on the Service.
General surgery residents rotate both at the VA and MUSC as the chief of the vascular surgery service. Exposure is gained in both open and endovascular technique. A typical week for a vascular resident includes two endovascular aneurysm repairs, 2-3 endovascular interventions for lower extremity occlusive disease; 1-2 lower extremity bypass procedures, and 1-2 carotid endarterectomies.
Experience in Plastic Surgery is gained at the PGY 1 level during a one month rotation at MUH. This experience includes assisting in the management of inpatients as well as performing evaluations and workups on plastic surgery patients under the supervision of the attending staff. In addition to operative care, Patients are seen in the ambulatory care setting at the Plastic Surgery outpatient clinics at MUH and VA. Residents on General Surgery at VA also often participate in the pre-, intra-, and postoperative care of Plastic Surgery patients at that institution.
Critical Care Management & Endoscopy:
The residents have opportunity to manage patients with complex medical problems and those requiring major resuscitation, critical care and nonoperative trauma care. These opportunities primarily occur in the Surgical Trauma ICU (STICU) and the Cardiothoracic ICU (CTICU). In addition, Surgery Residents are provided a plethora of endoscopy opportunities early during their training.
Simulation is essential to modern surgical education. With the MUSC surgery simulation curriculum, our mission is to cultivate the technical and cognitive skills development of our bright surgical trainees in an environment optimally focused on their education, without distractive concerns of service. With this training, we improve quality of delivered care and improve patient safety, while empowering the capable surgeons of tomorrow.
The MUSC Simulation Center is a state-of-the-art 11,000 square foot training facility featuring 14 simulation rooms. Here, with both high-fidelity mannequins and models, residents can participate in a variety of programs such as Difficult Airway Lab, Central Line Courses, Acute Traumatic Life Saving Procedures, Lumbar Punctures, and more.
Throughout training, residents have the opportunity to participate in ex-vivo and in-vivo animal labs that allow for hands on real-world training in laparoscopy and robotics. Additionally, our curriculum incorporates flexible endoscopy (FES) and fundamentals of laparoscopy (FLS) which prepare residents for their board requirement tests. Additional sessions include thyroid and emergency ultrasound, suture and wound closure devices, vascular anastomosis, operative energy devices, and more.
*The MUSC Simulation Center is an official FLS testing center.
|First Time Board Pass Rate 2012-2016|
| ||Qualifying Exam|
Evaluation and Milestones
Evaluation of the Residents
Each resident receives a clinical evaluation at the completion of each rotation, which may last from 1 to 3 months, depending on postgraduate year. In addition, at the completion of each academic year a composite evaluation of each resident is made by the Department of Surgery Graduate Medical Education Committee to review the overall clinical evaluations, ABSITE scores, and research project. Evaluations are communicated to each resident biannually by their faculty advisor and Clinical Competency Committee. Both the faculty advisor and the CCC (ACGME Milestones) meet with the residents and review all of the written evaluations to date. At that time the advisor will also discuss their research efforts, performance in Basic Science, Mock Orals and Simulation Lab. They will discuss concerns about the program, and desired goals and directions for their surgical careers. The residents are also advised to review their evaluations at the completion of each rotation. Residents always have access to their own evaluation files during regular business hours. If a resident is to receive an evaluation of unsatisfactory, the evaluating faculty will discuss this with the resident prior to submitting the evaluation. When this evaluation is received by the program director, he will again discuss this evaluation with the resident promptly. The goal of this policy is for deficiencies and problems in performance to be identified as soon as possible so that the appropriate corrective action may be taken.
Resident Evaluation of the Program
At the completion of each rotation, each resident will complete a standardized evaluation form designed and provided by the Office of Graduate Medical Education of the MUSC College of Medicine. Evaluation of both the clinical rotation and that of faculty teaching skills are included. Such evaluations are submitted in a confidential manner to the Residency Program Coordinator and reviewed by the Program Director. At the completion of the academic year the faculty evaluations are tabulated, summarized so as to ensure anonymity, and provided to the Department Chairman, Program Director, and each faculty member within the Department. In addition, each faculty member receives his own evaluation. Evaluations of the clinical rotations are collated and provided in an anonymous fashion to the Department Chairman, Program Director, and Section Heads of the services. In the event of a serious acute problem in resident evaluation of either faculty or rotation, this information is discussed immediately with the Section Head by the Program Director in order to initiate corrective action. The overall collated information of faculty evaluations and clinical rotations is discussed by the Department of Surgery Graduate Medical Education Committee/ Program Evaluation Committee during the planning sessions for the upcoming year.
Residents provide month ongoing input regarding any training or institutional related issues during the monthly Program Evaluation Committee meeting. In addition to the Administrative Chief Resident, residents nominate a member from the PGY4, 3, 2, 1(categorical) and 1(preliminary) class to serve on this committee. Residents are also invited to an every other month resident informational with the Program Director and Department Chair. Chief Residents meet weekly with the Program Director and Department Chair to discuss program or hospital issues in a time sensitive manner.
Separate night float call systems have been developed for Trauma and Pediatric Surgery at the Main Hospital and GI Oncology Surgery, GI Surgery and Vascular Surgery at the Ashley River Tower Hospital. According to this system, residents at all levels rotate from 1 to 3 months, depending on postgraduate year. During this rotation, night call is covered by a group of residents from 6 pm to 7 am, so that residents on the regular services do not have on-call duties in the hospital at night, other than an average of every fifth weekend/holiday day. For VAMC Surgery, resident call is very 4th night home call for the PGY3 and PGY5 residents. PGY1 residents on non-general surgery rotations (e.g, Cardiothoracic) cross-cover for an average of every 4th night, with call taken at home for all services except Cardiothoracic. Residents will have at least one day out of seven free of routine responsibilities.
The Department of Surgery takes duty hours compliance very seriously. Residents as well as the program director are notified weekly of delinquent duty hours recording and thus the situation is able to be remedied immediately.
The complete duty hours policy can be found here
Optional Dedicated Research Year(s)
Residents may choose to take advantage of the opportunity to spend one to two years in a research laboratory within the Department of Surgery after completing the PGY 2 year. Typically two residents per year will spend time in the research lab. Approximately 8 months prior to the end of their PGY 2 year residents who wish to do research are expected to identify an area of particular interest and a Departmental surgical attending research mentor willing to supervise them. A project is developed for which the resident serves as the principal investigator. Usually two residents a year are chosen or are assigned to the research program, but more than 2 residents have been accommodated in the past when more residents have desired this protected research time.
Lab residents are trained in a number of experimental surgical, molecular, and biological techniques appropriate to their area of study. Residents are expected to review and present topics of interest in weekly research conferences. At the beginning of the research year, residents enroll in a biostatistics course in addition of learning basic computing skills such as data management, statistical evaluation, and oral presentation. Specific projects are chosen for which there is a reasonable expectation that the origination of the research hypothesis, hypothesis testing, and critical review of the data can be performed within the given time period.
Residents in the lab are given the opportunity to attend at least one national surgical meeting where research is formally presented, with the opportunity to attend any additional meetings during this or subsequent years in which they are invited to present their own research. By the end of the lab experience, the resident will have participated in the preparation of at least one manuscript as the principal author, based on the primary project. This is expected to include a fully developed critique of the results, as well as discussion with respect to limitations, implications, and future directions of the research. The results from this study are submitted in abstract form to the appropriate surgical meeting venue, and if accepted, the residents participate directly in abstract/manuscript preparation and presentation.
Excellent research opportunities are present in the following research efforts within the Department:
- Oncologic and Endocrine Surgery
- Transplant Surgery
- Cardiothoracic Surgery
- Trauma/Critical Care Surgery
Research efforts at institutions such as the NIH are also supported.
Required Research Experience
In addition to the optional basic science experiences outlined above, residents are required to participate in the Resident Research Program Requirement. By the completion of their PGY 5 year, all residents will have produced 2 clinical/basic science/health services research projects manuscripts of publishable quality and one quality improvement/process improvement project. For those residents who spend time in the lab, their work from that experience will count towards this effort. All categorical residents who participate in the Research Program outside of the lab are guided by Dr. Carneiro-Pla under the clinical research curriculum. Residents choose their own mentor and project and are provided with educational tools and resources to equip them in their efforts under their chosen mentor guidance. Yearly, the residents show case their efforts on during the MUSC Research Recognition Day where they present their work and compete for Department prizes.
The Medical University of South Carolina participates in the National Resident Matching Program (NRMP). This process selects all PGY-1 residents in the institution. The general surgery residency program has 5 categorical positions and 14 preliminary positions at the PGY-1 level.
For the 2017-2018 interview season (PGY-1 beginning July 2018), applications will be accepted ONLY through ERAS.
In addition to the ERAS application we require a transcript of your grades, Dean's letter, three letters of recommendation and USMLE scores. The deadline for receipt of applications is October 1, 2017
. We will not review any applications received after this date. The residency committee reviews each applicant's preliminary file and makes a decision whether or not the applicant will be interviewed, placed on a waiting list or not be interviewed. After the preliminary evaluation you will receive an email from us indicating your status. The department uses the Interview Broker scheduling system and correspondence will be sent through this program. If you are selected for an interview your email will ask that you schedule your interview using Interview Broker (the link will be provided to you in the email). You may also call the Department of Surgery at any time if you have questions. You should contact Sue Wetherholt, the Residency Program Coordinator at (843) 792-3072 or via email at firstname.lastname@example.org
. At that time she will indicate whether your letters of recommendation are complete and will answer any other questions you may have.
We are offering the following dates for interviews: