The primary goal of the University of Puerto Rico surgical residency training program is to prepare each resident to be successful in the career path he/she chooses whether academics, subspecialty, rural or other private practice. Graduates of this program are competent to enter a fellowship or private practice or to continue on in an academic career. Surgical residency training is a high priority item for the faculty of the Department of Surgery. Through close supervision, the surgical staff provides teaching at each level for the residents with a well-organized program of increasing responsibility throughout the five-year program.
The General Surgery curriculum is highly comprehensive and includes didactic, research and clinical training. The program stresses all aspects of diagnostic work-up, preoperative preparation, intraoperative judgment, surgical technique, postoperative management and follow-up care. The extensive variety of clinical problems confronted at this multi-hospital complex allows each resident to have the opportunity to observe and experience firsthand the complexities of the response of the surgical patient to disease, trauma, and operative intervention.
What is expected per year?
The goal of the first year is the development of expertise in patient management. Objectives include acquiring basic operative skills, learning to set priorities in patient management, developing problem solving skills, leadership, and teaching skills. The first-year trainees (PGY-1) rotate through all the medical center hospitals. The PGY-1 resident functions as part of a surgical care team. Responsibilities include evaluation and planning for treatment of patients, attendance at rounds, clinics and conferences; assisting in the operating rooms and participating with the educational staff for junior and senior medical students during their surgical clerkships and elective rotations. PGY-1 residents are expected to assume primary care for patients on their service on a day-to-day basis. They are expected to understand and perform the various tasks required for the care of patients with complex problems and those that are clinically ill. The PGY-1 should gain valuable operating room experience both as an assistant as well as an operating surgeon working under close faculty supervision. About half of the first year is spent in general surgical rotations and the remainder in the specialty services. The latter include experience in tumor surgery, plastic surgery, pediatric surgery, transplantation surgery, vascular surgery, trauma surgery, cardiothoracic surgery and surgical critical care. Electives are also available in orthopedics, neurosurgery, otolaryngology (head and neck), urology, anesthesia and ultrasound radiology.
During the second year (PGY-2), subspecialty exposure is broadened to include rotations in which experience was not obtained in the first year. On the General Surgery services, the operating experience extends significantly and involves opening and closing laparotomy wounds, more complicated hernia repairs, some trauma and less complicated gastrointestinal and biliary procedures, etc. An increasing amount of clinical independence also is achieved.
The goal of the third year residency program (PGY-3) is the development of surgical skills. The resident participates in consultations, decision-making and a greater number of major procedures. This year is designed to strengthen the resident’s education in general surgery and is a key year for operative experience rotating on general surgery.
In the final two years of training, the senior resident assume responsibility in all surgery rotations. Major operative procedures are performed under the direct supervision of a senior staff surgeon. These years are designed to provide increasing senior level responsibility in patient care decision making and allow each individual to develop qualities of maturity and judgment which are the essence of the skilled surgical practitioner. The senior resident is required to prepare and present professional papers at conferences and is responsible for the teaching and training of junior house officers and students on his/her service. The final year of the General Surgery experience completes a progressively graded comprehensive training program with increasing responsibility and accountability as required by the American Board of Surgery.
Dr. William Méndez Latalladi