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General Surgery Residency Curriculum

IU School of Medicine General Surgery Residents experience a broad-based clinical education and advanced training in the operating room as well as at the bedside. This five-year program exposes residents to all facets of surgery, including trauma, vascular, pediatric, transplant and reconstructive surgery.

Year One

First-year general surgery residents at IU School of Medicine rotate at all five of the school’s downtown Indianapolis clinical facilities and serve as members of the assigned surgical care team. Residents evaluate and plan for the treatment of patients; attend rounds, outpatient clinics and conferences; assist in the operating room; and participate as a member of the educational staff for third- and fourth-year medical students during their surgical clerkships.

PGY 1 residents receive indirect supervision by senior residents and faculty attendings. During this first year, residents learn to assume daily primary care responsibility for patients on their service, to understand complex problems of critically ill patients and perform mandated interventions when necessary. The main goal of the PGY 1 experience is to ensure that residents understand the principles of pre- and post-operative care. Residents gain valuable insight in the operating room as both first assistant and surgeon junior under the direct supervision of faculty attendings or senior residents. Regardless of categorical or preliminary match status, all first-year residents gain corresponding exposure and experience in general, vascular, pediatric, transplant and trauma surgery as well as experience in the surgical intensive care unit (SICU).

First year general surgery residents, on average, take call every fourth night at IU Health Methodist Hospital and Riley Children’s Hospital, and alternating weekend call at Sidney and Lois Eskenazi Hospital, Richard L. Roudebush VA Medical Center and IU Health University Hospital. All first-year surgery residents participate in a month-long block of night float. Rotations last for one month and are not to exceed the 80-hour work week.

PGY 1 Rotations

  • IUH University Hospital Team A (General Surgery/HPB)
  • IUH University Hospital Team B (General Surgery/Colorectal)
  • IUH University Hospital Team C (General Surgery/HPB)
  • IUH University Hospital Team D (General Surgery/Endocrine)
  • IUH University Hospital Transplant
  • IUH University Hospital Night Float IUH Riley Hospital (Pediatric Surgery)
  • Roudebush Veterans Affairs Hospital General Surgery
  • Sidney & Lois Eskenazi Hospital SICU
  • Sidney & Lois Eskenazi Hospital Team 1 (General Surgery)
  • Sidney & Lois Eskenazi Hospital Team2 (General Surgery)
  • Sidney & Lois Eskenazi Hospital Team 3 (Trauma Surgery)
  • IUH Methodist Hospital Trauma Surgery
  • IUH Methodist Hospital Green A (General Surgery)
  • IUH Methodist Hospital Green B (General Surgery)
  • IUH Methodist Hospital Emergency General Surgery

Rotations are always subject to change. Categorical intern rotation schedules are often “super blocked,” allowing for more opportunities for continuity of care along with developing relationships with operative faculty in order to gain the most possible out of the rotation. In addition, all PGY 1 residents acquire Advanced Trauma Life Support (ABLS) training through the Smith Level I Shock Trauma Center at Sidney and Lois Eskenazi Hospital.

Year Two

Second-year general surgery residents at IU School of Medicine rotate at all five of the school’s clinical partner facilities in downtown Indianapolis as well as Franciscan Health Indianapolis for endoscopy and IU Health North.

PGY 2 residents continue the first-year residency work of evaluating and planning for the treatment of patients; attending rounds, outpatient clinics and conferences; serving as surgeon junior when the opportunity presents itself; and participating as a member of the educational staff for third- and fourth-year medical students during their surgical clerkships. Regardless of categorical or preliminary match status, all surgery residents gain exposure during their second year to general, vascular, pediatric, thoracic, plastic/burns and trauma surgery as well as experience in the surgical intensive care unit (SICU) and the trauma intensive care unit (TICU). Second- year residents should experience appropriate increases in both clinical and operative autonomy to ensure preparation to take on a mid-level role in the PGY 3 year.

PGY 2 residents, on average, take call every fourth night at Riley Children’s Hospital, and alternating weekend call at IU Health Methodist, Sidney and Lois Eskenazi Hospital, Richard L. Roudebush VA Medical Center and IU Health University Hospital. All second-year residents participate in a month-long block of night float. Rotations away from the downtown IU School of Medicine campus are incorporated into either the Eskenazi Health or IU Health Methodist call pool as determined by the administrative chief residents. Rotations for all PGY 2 residents are one-month long.

PGY 2 Rotations

  • IUH University Hospital Team A (General Surgery/HPB)
  • IUH Riley Hospital (Pediatric Surgery)
  • IUH University Hospital Plastic/Burns
  • Night Float (Sidney & Lois Eskenazi Hospital or IUH Methodist Hospital)
  • Sidney & Lois Eskenazi Hospital Team 4 (Vascular/Thoracic Surgery)
  • IUH Methodist Hospital (Trauma Surgery)
  • IUH Methodist Hospital (Emergency General Surgery)
  • IUH Methodist Hospital (SICU)
  • IUH Methodist Hospital (TICU)
  • IUH Methodist Hospital (Vascular Surgery)
  • IUH North Hospital (General Surgery)
  • Endoscopy (Off Campus – St. Francis Hospital, Mooresville, Indiana)

Residents must achieve 250 cases by the end of their PGY 2 training year in order to advance to the PGY 3 level per new guidelines established by the American Board of Surgery.

Year Three

PGY 3 general surgery residents at IU School of Medicine rotate at all five of the school’s clinical partner facilities in downtown Indianapolis as well as IU Health West Hospital. The third year of residency training enables trainees to gain greater decision-making responsibility through consultation opportunities as the most senior-level resident on the transplant, SICU, breast surgery and IU Health West Hospital rotations. They also serve as the mid-level resident at the Smith Level I Shock Trauma Center at Eskenazi Health with a PGY 4 resident serving as their chief. PGY 3 residents are also allowed an elective month as a means for future career exploration. In the third year, residents should experience appropriate increases in both clinical and operative autonomy to ensure preparation to take on the appropriate chief-level rotations assigned during the PGY 4 year.

All PGY 3 residents gain experience in general, vascular, thoracic, plastic/burns, transplant and trauma surgery as well as in the surgical intensive care unit (SICU).

On average, PGY3 residents take alternating weekend call at IU Health Methodist Hospital, Eskenazi Health, Richard L. Roudebush VA Medical Center and IU Health University Hospital. All PGY 3 residents participate in a month-long block of night float. Rotations away from the downtown IU School of Medicine campus are incorporated into either the Eskenazi Health or IU Methodist call pool as determined by the administrative chief residents.

PGY3 Rotations

  • Night Float (IU Health University Hospital)
  • Night Float (Sidney & Lois Eskenazi Hospital or IU Health Methodist Hospital)
  • IU Health University Hospital Team B (General Surgery/Colorectal)
  • IU Health University Hospital Team D (General Surgery/Endocrine)
  • IU Health University Hospital Transplant
  • IU Health University Hospital SICU
  • Roudebush Veterans Affairs Hospital General Surgery
  • Roudebush Veterans Affairs Hospital or Sidney & Lois Eskenazi Hospital (Thoracic/Vascular Surgery)
  • Sidney & Lois Eskenazi Hospital Team 1 (General Surgery)
  • Sidney & Lois Eskenazi Hospital Team 3 (Trauma Surgery)
  • IU Health West Hospital (General Surgery)
  • Elective

Residents in the PGY 3 year participate in the ASSET (Advanced Surgical Skills for Exposure in Trauma) course taught by IU School of Medicine trauma surgeons at Eskenazi Health and IU Health Methodist Hospital. This curriculum is sponsored by the American College of Surgeons. PGY 3 residents also participate in lap crisis simulation sessions at the school’s Simulation Lab at Fairbanks Hall in Indianapolis.

Year Four

PGY 4 general surgery residents at IU School of Medicine rotate at all five of the school’s clinical partner facilities in downtown Indianapolis as well as IU Health North. Fourth-year residents gain an increased level of responsibility through consultation opportunities as the most senior-level resident on trauma, pediatric surgery and apprentice rotations, including colon recta, hepatobiliary, surgical oncology and minimally invasive surgery. In addition, fourth-year residents experience an increase in their leadership responsibilities on assigned services as a senior-level resident.

PGY 4 residents begin to take part in the aforementioned apprentice rotations, which are two consecutive blocks of rotation where a PGY 4 or PGY 5 resident is assigned to one or two faculty members for the duration of the rotation. The goal of this apprentice model is to increase autonomy given by the faculty member and increase technical ability by the resident in the operating room. Half of the academic year is set up in an apprentice model, and the remainder of the year follows the one-month rotation set up in areas of trauma surgery, general surgery, endocrine and pediatric surgery.

PGY 4 residents are also allowed an elective month for future career exploration. The international general surgery elective in Eldoret, Kenya (Moi University) is an elective option during this year as long as the PGY 4 resident is in good standing as defined by the Department of Surgery.

All PGY 4 residents participate in a month-long block of night float. PGY 4 residents, on average, take call every fourth night at Riley Children’s Hospital, and alternating weekend call at IU Health Methodist, Eskenazi Health, Richard L. Roudebush VA Medical Center and IU Health University Hospital. Rotations away from the downtown campus are incorporated into either the Eskenazi Health or IU Health Methodist call pool as determined by the administrative chief residents.

PGY 4 Rotations

  • IU Health University HPB Apprentice Rotation (two months)
  • Riley Hospital for Children Hospital (Pediatric Surgery)
  • Sidney & Lois Eskenazi Hospital Team 3 (Trauma Surgery)
  • IU Health Methodist Hospital (Trauma Surgery)
  • Night Float (Sidney & Lois Eskenazi Hospital or IU Health Methodist Hospital)
  • Sidney & Lois Eskenazi Hospital Team 4 (Vascular/Thoracic Surgery)
  • IU Health Methodist Hospital Green B (General Surgery)
  • IU Health Methodist Hospital (Trauma Surgery)
  • IU Health University Hospital Team D (General/Endocrine Surgery)
  • Elective

Elective Options

  • IU Health Ball Memorial in Muncie, Indiana – general surgery (housing provided)
  • Goshen Hospital in Goshen, Indiana – general surgery (housing provided)
  • Harrison County Hospital in Corydon, Indiana – rural general surgery (housing provided)
  • Plastic Surgery (Indianapolis campus)
  • Vascular Surgery (Indianapolis campus)
  • Colorectal Surgery (St. Francis – Mooresville, Indiana; PGY 4 only)
  • Cardiothoracic Surgery (Indianapolis campus)
  • IU Kenya/Eldoret (PGY 4 only)

Year Five

The fifth year of general surgery residency training at IU School of Medicine is the chief resident year. During this year, residents assume senior-level responsibilities in both clinical and operative decision-making and provide appropriate oversite for PGY 1 – 4 residents and surgery clerkship students. PGY 5 residents take on leadership and education roles for residents and medical students and are responsible for the management of all the patients on their service. All surgical consult requests from other departments funnel through the PGY 5 resident.

PGY 5 general surgery residents at IU School of Medicine rotate at all five of the school’s clinical partner facilities in downtown Indianapolis and at IU Health North.

Fifth-year residents continue to participate in assigned apprentice rotations into the final year of Chief Resident training. This apprentice model increases the resident’s autonomy and enhances technical ability by the resident in the operating room. Half of the academic year is set up in an apprentice model, and the remainder of the year follows the one-month general surgery rotations.

All PGY 5 residents participate in a month long block of night float. PGY 5 residents take home-call at IU Health University Hospital and alternating weekend call at IU Health Methodist, Sidney and Lois Eskenazi Hospital and Richard L. Roudebush VA Medical Center.

PGY 5 Rotations

  • Colon-Rectal Apprentice Rotation (two months; IU Health North Hospital, IU Health University Hospital, and Sidney & Lois Eskenazi Hospital)
  • MIS Apprentice Rotation (two months; IU Health North Hospital – can be done in lieu of two GS months)
  • General Surgery Rotation at Sidney & Lois Eskenazi Hospital, IU Health Methodist Hospital, or Roudebush Veterans Affairs Hospital (four months – two sites/two consecutive blocks)
  • Night Float (Sidney & Lois Eskenazi Hospital or IU Health Methodist Hospital )
  • IU Health Methodist Hospital (Emergency General Surgery)
  • Elective
  • IU Health North Hospital (General Surgery/MIS)

Elective Options

  • IU Health Ball Memorial in Muncie, Indiana – general surgery (housing provided)
  • Goshen Hospital in Goshen, Indiana – general surgery (housing provided)
  • Harrison County Hospital in Corydon, Indiana – rural general surgery (housing provided)
  • Plastic Surgery (Indianapolis campus)
  • Vascular Surgery (Indianapolis campus)
  • Colonrectal Surgery (St. Francis – Mooresville; PGY 4 only)
  • Cardiothoracic Surgery (Indianapolis campus)
  • IU Kenya/Eldoret (PGY 4 only)