Post-Graduate Year 1 (PGY1): The internship provides an extensive experience in the essentials of pre- and postoperative care for the general surgery patient. First-year residents become competent in managing critically ill patients, and they begin to develop technical skills in operative surgery. The PGY1 year includes rotations in the core general surgery services of Endocrine/Oncologic Surgery, Hepatobiliary Surgery, Colorectal Surgery, Thoracic Surgery, Trauma/Acute Care Surgery, Transplant Surgery and Vascular Surgery. Rotations in Pediatric Surgery and in the Surgical Intensive Care Unit also are provided in the first year. The majority of the PGY1 rotations are scheduled at Barnes-Jewish Hospital. Interns also get to experience community General Surgery at Barnes-Jewish West County.
Post-Graduate Year 2 (PGY2): In the second year, clinical responsibility and operative experience increase. The PGY2 schedule includes rotations in Trauma/Acute Care Surgery, Endocrine/Oncologic Surgery, Minimally Invasive Surgery and Vascular Surgery. In addition, there are rotations in the Surgical and Cardiothoracic ICUs and Pediatric Surgical Service. General Surgery PGY2 residents rotate at Barnes-Jewish Hospital and the St. Louis VA Medical Center-John Cochran Division. On many services, the PGY2 residents see both the ED and inpatient consults.
Post-Graduate Year 3 (PGY3): The third year provides advanced experience on the general surgery services of Acute and Critical Care Surgery, Colorectal Surgery, Hepatobiliary Surgery, Thoracic, Vascular and Pediatric Surgery. Third-year residents also have a dedicated Endoscopy Rotation to master EGDs and colonoscopies.
Post-Graduate Year 4 (PGY4): During the fourth clinical year of the program, the residents begin to act as chief residents on the Trauma/Acute Critical Care Service, where they often get the opportunity to take junior residents through operations. In the fourth and fifth years, residents may choose to participate in the Flexibility in Surgical Training (FIST) program where they may be able to customize 12 months of elective rotations over the last 2 years of residency. This may include surgery rotations such as Minimally Invasive Surgery, Thoracic, Transplant, Colorectal, Hepatobiliary, Cardiac and/or Vascular but also non-surgery rotations such as Interventional Radiology and Neonatal Intensive Care.
Post-Graduate Year 5 (PGY5) (Chief Resident): During the final year of the program, the resident rotates at Barnes-Jewish Hospital on the Hepatobiliary Surgery, Colorectal Surgery, Minimally Invasive Surgery and Endocrine/Oncology Surgery services. The chief residents also do General Surgery rotations at the VA Medical Center and Barnes-Jewish West County. Again, chief residents may also participate in the FIST program and customize a portion of their schedule based on their own interests. Working under the guidance of attending surgeons, the chief resident is responsible for the administration of the service and actively participates in the organization of conferences and teaching junior surgical house officers and medical students.
Residents rotate on clinical services for four- to eight-week blocks, depending on their clinical year. These blocks are coordinated among the various clinical years and align the education component of the training program.
On various services with subspeciality fellows, the roles of the fellows and chief residents are strictly separated by attendings. In this way, the presence of a fellowship does not detract from the operative experience for the general surgery residents.
The call schedule operates on a combination of night float system and home call. During the first year, PGY1 residents do not have any call periods longer than 16 hours to comply with the ACGME duty hours requirements. During the PGY2, PGY3 and PGY4 years, most residents who are not on night float take in-house call on average either 1 in 7 or 1 in 14 days. Chief residents do not take in-house call and are home one to two weekend calls per month and take home call during the week. The call schedules are designed to comply with all aspects of the 80-hour work week regulations. We are currently participating in the FIRST trial, which permits more flexibility of duty hours, while still maintaining the strict 80-hour limit. Click here to learn more.
Resident Complement (2015-2016)
Resident distribution by rotation and PGY year is shown in the table below for 2015-2016. Class numbers as they appear here are variable due to differences in research time and flexibility in rotation schedule.
Rotation schedules are modified annually based on resident feedback.