1.   Are there any major changes in the program over the next year?

2.    What are the programs efforts to improve Wellness and reduce Burnout?
3.   What is the main strength of this program? How does it differ from other similar programs?
4.   And its main weakness?
5.   How are the educational conferences structured?
6.   What are the number of calls?
7.   What are the research opportunities? What about research presentations? Where do residents usually present their work?
8.   What about attending national conferences and review courses?
9.   What are the 2012-2016 Board pass rates of the program?
10. What were the last ACGME citations and what has been done about them?
11. What is the attrition rate of the program?
12. What about international rotations?
13. Are there any additional perks not mentioned elsewhere?

1.   Are there any major changes planned for the program over the next year?

The program is educationally and functionally stable. While there are no transformational changes planned, incremental changes will be made. The hospital has recruited transplant, colorectal, and pediatric surgeons over the past year. These surgeons have enhanced the number and variety of the clinical experience. On the surgical side, the program has embraced the role of robotic surgery and the general surgeon. Residents matching into the program will be expected to obtain basic robotic competency. A robotic simulator has been purchased to help in training of faculty and residents.

The final word on Graduate Medical Education and Healthcare is currently under debate in Washington and Chicago and the program continues to be vigilant.

As these broader issues get sorted out it can be expected that the program you finish your surgical training in 2025 will look very different than the program you start your intern year in.

 

 2.   What are the programs efforts to improve Wellness and reduce Burnout?

There has been addition of a PA to the trauma service. Schedules have been modified to ensure a mix of easy and difficult rotations during each academic year. The number of calls has been kept to under 6 a month to reduce fatigue and burnout. 

The mentoring program has been modified with residents having their choice of mentors. The mentors pro-actively check in on the residents once a quarter and more times if need be. Free counseling is available for at risk residents.

Graduate medical education provides each resident $200 a year to decrease cost of gym memberships. This money can be used for other activities such as yoga classes, kick boxing or the cost of a Fitbit. The program has a monthly10,000 steps a day challenge. The resident that has the most days of 10,000 steps for the month wins an additional $200 in Wellness money.

A Heart Math program will be instituted to promote resilience. Residents will be instructed in skills to cope with stress and better manage their emotions. 

Last year the department generously paid for many resident parties and team building events. There was a Welcome party, Christmas party, Whirly Ball, Clay shooting and a Graduation Roast. Similar events will continue this year.

Residents are provided a jacket with their names embossed on it. The department pet dog Paxton and the vegetable garden are other destressing activities. 

The program will be randomized in the SECOND trial run by the ABS, APDS and ACGME.

3.   What is the main strength of this program? How does it differ from other programs?

It is not fair and often impossible to make direct comparisons between similar programs. We believe we have a collegial learning environment and abundant clinical material. Our board pass rates are consistently above the national average and reviews of our graduating resident surgical acumen have been good. Graduating residents going on to do General Surgery have felt comfortable in independent surgical practice. There is good direct and indirect mentorship as shown by our academic output and placement of residents in competitive fellowships.

The program takes considerable pride in many of our residents who practice independently in rural areas on graduation

 

4.   And its main weakness?

Opportunity to do bench research is limited. The program does NOT have an opportunity to take a year off to do research. Our focus is on training clinically strong operating surgeons in 5 years.

The thoracic surgery rotation can be improved. While there are enough cases for graduation, the academic nature of the program can be improved.

5.   How are educational conferences structured?

The program has 5 hours of protected time for educational conferences. Residents are free of all clinical responsibility except the care of life threatening emergencies.

The conferences begin on Monday from 7.00 – 8.00 AM. This time is used traditionally for ABSITE and board review and administrative issues.

Thursdays are our main conference day. The conferences run from 7.00 AM to 9.00 AM and include SCORE topics, basic science lecture series, grand rounds, trauma conference, tumor board, journal clubs and a weekly M and M conference.

On Tuesdays, interns have simulation early in the year and ABSITE review classes from September to January. Second years are instructed in FLS skills from February to June.

Residents are exposed to 2 mock oral exams in the year and ABSITE review sessions are held frequently from November to January. 

6.   What are the number of calls?

Call averages once every 5 nights and it is in-house. We do not have a night float and call tends to be busy. Our ER sees over 115,000 visits a year and the staff and trauma services are busy.

PGY-5 residents take 6 calls from home. They come in for operative cases and for Level 1 Trauma activations.

7.  What are the research opportunities? What about research presentations? Where do residents usually present their work?

Research activity is particularly robust for an independent academic center with regular presentations at Detroit Surgical, Midwest Surgical Association, Michigan Chapter and the American College of Surgeons Clinical Congress. A proxy for the research activity is the fellowships that our residents have garnered over the years.

Research opportunities are primarily clinical outcomes research. Research is done concurrent to the clinical program. Each resident is required to complete a research project prior to graduation. Many residents complete more than one project.

There are clinical databases in Surgical Oncology, Breast and Bariatric surgery to help in your research. There are also statisticians and post-doctoral fellows available to help formulating your project. Dr. Richard Haywood is our in-house PhD to help with your projects.

A full list of our research activity can be found under the research tab on this website.

8.  What about attending national conferences and review courses?

All residents have the option of attending the Detroit Trauma Symposium. PGY-3 to PGY-5 residents have additional funding to attend a national conference or review course. Senior residents traditionally have used these funds to attend the American College of Surgeons Clinical Congress or national level meetings in the allied surgical specialties.

Residents presenting their research will have their expenses covered by the department.

9. What are the 2012-2016 Board pass rates of the program?

The ACGME and ABS have gone to independently reporting 3-year first time oral and written exam pass rates. The 3-year first time written exam pass rate is 100% and is the 99th percentile in the country.

The 3-year first time oral exam pass rate is 87% and it is 69th percentile in the country.

10. What were the last ACGME citations and what has been done about them?

The program has no citations and is fully accredited.

11. What is the attrition rate of the program?

The attrition rate is 18% for residents who directly matched into the program. Attrition has been due to change of career plans, not being a fit for this program and due to lack of ability to complete a surgical program. As you may have well guessed by now, Surgery is not for everyone. The program makes every effort to aid at risk residents to complete the program or find alternate careers suited to the residents’ abilities.

12. What about international rotations?

There are currently NO options for international rotations. We are constantly re-evaluating this issue from multiple angles – educational rationale, service vs. education, resident safety, supervision, and costs. This may become an option in a few years, but this is not an option at present.

13. Are there any additional perks not mentioned elsewhere?

The program is well funded and departmental support for resident education is at an all-time high. Residents automatically become members of the American College of Surgeons and the Detroit Surgical Association. Residents are invited to attend all dinner meetings of the Detroit Surgical Association and the Academy of Surgery. Latest edition books, SESAP during your PGY-3-year, surgical loupes as a PGY-2, meal card ($1500), and free parking are some of the additional perks not mentioned elsewhere.

Any research project accepted for presentation at a regional meeting is fully paid for along with time off that does not count towards vacation time. There are professional development funds that varies between $600-2200 per year.

These perks compliment the strong academic and clinical program at St. John.