The primary clinical and research goals of this program are to produce surgeons who will be leaders in the fields of breast cancer and investigative research. Concomitant with this goal is the expectation that the fellow will become proficient in educating and mentoring others. Washington University School of Medicine regards the education of medical students as the core of its mission. Similarly, the Department of Surgery regards the education of the surgical resident as a primary responsibility. The goal of this particular fellowship is to enhance the education of medical students and surgical residents on the service. In particular, regarding surgical resident training, this fellowship is intended to augment the educational experience of the resident rather than to detract from, or infringe on, their educational and operative experience. To that end, the fellowship program director will work closely with General Surgery Program Director Michael Awad, MD, and Surgical Residency Coordinator Michele Bowman to ensure that the fellowship training complements and enhances the surgical residence experience. To facilitate this goal:
- Residents on the Unit I Service (Surgical Oncology) are expected to participate in the preoperative evaluation of patients at the Breast Health Center.
- The fellow will assist, teach and mentor residents in the evaluation and use of operative procedures on patients, when appropriate and under the supervision of the attending faculty. The fellow will be evaluated by faculty and residents on teaching effort and skills. A resident (PGY1-3, but not the chief resident) on the Unit I Service will be encouraged to participate with the fellow in operations performed on patients with breast disease. The attending surgeon will designate the appropriate intraoperative roles for the fellow and resident, depending on their respective experience and capability.
- Immediately prior to the operative procedure, the fellow will review with the resident 1) the indications for the specific operation, 2) alternative procedures, 3) pertinent breast imaging studies or other tests, 4) the operative plan and 5) expected benefits and usual risks.
- The fellow will assume primary responsibility for the pre- and post-operative care, orders and subsequent follow-up of all patients operated on by the fellow. The fellow will attempt to join the residents on daily rounds on the breast surgery patients. If that is not possible (e.g., attendance at conferences), the fellow will discuss postoperative care, discharge plans and other aspects with the surgery resident(s) involved with the patient at a time convenient to the resident. The fellow will be responsible for writing daily notes on these patients or notes when appropriate, and the fellow is responsible for dictating the discharge summary.
- The fellow will keep a log of all procedures and operations performed, including the name and level of the resident and the role of the fellow and the resident (e.g., teaching assistant, first assistant). This log will be reviewed semiannually by the program director and Dr. Awad to ensure adequate resident experience in breast surgery. They also will review the resident experience in breast surgery when the fellow is not involved. These data will be presented on an annual basis to the Surgical Residency Committee for their review.
- Resident presentations on topics related to breast disease for the Surgical Grand Rounds will be reviewed with the fellow as well as the responsible attending surgeon. The fellow will assist the resident by reviewing content, data and other aspects of the presentation prior to Grand Rounds.