General Surgery Residency Rotations

Training during the first two years in our general surgery residency program provides a sound background for increasing responsibility for patient care. Residents are assigned to surgical rotations at affiliated hospitals in the Texas Medical Center, where they gain extensive exposure and opportunities to participate in operative procedures and clinical care. Residents work directly with experienced surgical faculty in an environment where progressive, supervised operative experience is available. Rotations include many of the general surgical rotations as well as the intensive care unit, emergency center, and some surgical specialties.

At Ben Taub Hospital, the PGY-2 resident serves as consult to the emergency room, and is responsible for coordinating all aspects of the emergency room. For example, residents run the shock room, managing penetrating and blunt trauma. At Ben Taub Hospital, PGY-2 residents also rotate on the elective surgery service.

During the third year, residents receive increasing graded responsibility in the care of their patients, under the supervision of the chief resident and faculty. They find this time to be a pivotal transition into the role of team leader and for personal and professional growth as they progress into their fourth year of training.

General surgery residents in the third year rotate on the pediatric surgery service at Texas Children’s Hospital, acute care and oncology services at Michael E. DeBakey Veterans Affairs Medical Center, and the thoracic surgery, acute care surgery, oncology surgery and general surgery services at Baylor St. Luke’s Medical Center. In addition, they rotate onto the general surgery service at The University of Texas MD Anderson Cancer Center, functioning with a team on this quaternary referral surgical oncology service.

While rotating at Texas Children’s Hospital, the third year resident serves as chief of the rotation, leading his or her team of residents under the direction of the pediatric surgery faculty and fellows.

At Michael E. DeBakey VA Medical Center, the resident serves as the associate chief of the general surgery and vascular surgery services, working with the chief residents and attending faculty. Residents gain a wide range of clinical operative experience as surgeons.

The fourth year of our training program is marked by resident transition into service leadership roles and acceleration of our graduated engagement responsibilities in the operating room. Residents continue to expand their technical skills and knowledge base and increase their operative experience as surgeons. Residents lead or assist fifth year chief residents in the management of the general surgery rotation while at Ben Taub Hospital. Residents gain extensive experience on the transplant surgery and general surgery rotations at Baylor St. Luke’s Medical Center, vascular surgery rotation at the Michael E. DeBakey Veterans Affairs Medical Center and vascular surgery rotation at Ben Taub Hospital.

The Michael E. DeBakey Department of Surgery has also coordinated an elective rotation within the Texas Medical Center and a unique and extremely popular elective community surgery rotation with Penrose-St. Francis in Colorado Springs, Colorado as part of our fourth year curriculum. Penrose-St. Francis Health Services is a full service, 522-bed facility that provides residents with the opportunity to engage in a full range of surgical care in the community hospital setting. During this six-week rotation, general residents register case experiences in surgery and endoscopy many times that required for board certification. Weekend trips to the nearby mountain resorts are another favorite aspect of this experience.

Chief residents are assigned to surgical rotations at Ben Taub Hospital, Baylor St. Luke’s Medical Center, and Michael E. DeBakey Veterans Affairs Medical Center, where they have the opportunity to assume responsibility for performing operations independently while under faculty supervision. They are the leaders of their teams and coordinate all clinical activities for their rotation with the appropriate assistance of their assigned faculty member. Our chief residents’ direct service and administrative functions and report directly to the senior staff of the department at each institution, as well as to the program director, associate program director and chair.

The chief resident is expected to serve as a role model to residents and to develop growing leadership skills during their senior year, which will strengthen throughout the year as graduation approaches. In this context, two chief residents are elected by their peers and with department approval serve as executive chief residents meeting regularly with the department chair and program director to discuss issues and opportunities for the residency program. The executive chief residents also represent the senior members of the Resident Council, constituted of two members from each class also elected by their class peers. Resident Council members participate in monthly department Education Committee meetings and likewise meet regularly with the department chair and program director.

Our chiefs cap off their senior year and the entire course of their general surgery experience with their chief resident “Swan Song” presentation to the department during our final Grand Rounds of the academic year. During these highly anticipated talks, our chiefs share the most influential or memorable aspects of their years in training.

Rotations for PGY-1 Residents:

Ben Taub Hospital: (3 Months)
General Surgery/Acute Care/Trauma
Surgical/Trauma Intensive Care Unit

Michael E. DeBakey Veterans Affairs Medical Center: (3 Months)
General Surgery
Surgical Intensive Care Unit
Vascular Surgery

Baylor St. Luke’s Medical Center: (4 Months)
Transplant Surgery
Surgical Oncology
General Surgery
Cardiothoracic Surgery
Vascular Surgery

Texas Children’s Hospital: (2 Months)
Pediatric Surgery

Rotations for PGY-2 Residents:

Ben Taub Hospital: (6 Months)
Emergency Center
Vascular Surgery
Plastic Surgery
Surgical/Trauma Intensive Care Unit
Surgical Oncology

Michael E. DeBakey Veterans Affairs Medical Center: (3 Months)
Endoscopy
Surgical Intensive Care Unit
Vascular Surgery

Baylor St. Luke’s Medical Center (1 month)
Vascular Surgery

Texas Children’s Hospital: (1 Month)
Pediatric Surgery

Penrose/St. Francis Health System (Colorado Springs) (1 month)
General Surgery

Rotations for PGY-3 Residents:

Michael E. DeBakey Veterans Affairs Medical Center: (3 Months)
Surgical Oncology
Acute Care

Baylor St. Luke’s Medical Center: (4.5 Months)
Surgical Oncology/General Surgery
Acute Care
General Thoracic 

Texas Children’s Hospital: (3 Months)
Pediatric Surgery

The University of Texas MD Anderson Cancer Center (1.5 months)
Surgical Oncology

Rotations for PGY-4 Residents:

Ben Taub Hospital: (4.5 Months)
General Surgery/Acute Care/Trauma
Vascular Surgery

Michael E. DeBakey Veterans Affairs Medical Center: (1.5 Months)
Vascular Surgery
General Surgery 

Baylor St. Luke’s Medical Center: (3 Months)
General Surgery
Transplant Surgery 

Penrose/St. Francis Health System (Colorado Springs) (1.5 months)
General Surgery

Elective Rotation (within the Texas Medical Center) (1.5 months)
Plastic Surgery
Thoracic Surgery
Vascular Surgery 
Pediatric Surgery
Burns

Rotations for PGY-5 Residents:

Ben Taub Hospital: (5 Months)
General Surgery/Acute Care/Trauma
Surgical Oncology

Michael E. DeBakey Veterans Affairs Medical Center: (3 Months)
Surgical Oncology

Baylor St. Luke’s Medical Center: (4 Months)
Surgical Oncology
General Surgery

Our department offers one year of “preliminary” training for residents who need less than five years of general surgical training as a prerequisite for continued training in a surgical specialty, such as anesthesia or radiology. This preliminary general surgery experience is tailored to meet the needs of these residents in their chosen specialties. The specialty program directors, associate program directors and the general surgery program director and associate program director work collaboratively on the design of these rotations to ensure a diverse experience with exposure to a relevant general surgery experience. Assignments in general surgery are divided between the private and public hospitals.

The non-designated preliminary surgery program offers a wide variety of surgical experiences to residents who either did not match into their program of choice, or have decided to take a different path than the one they originally decided on in medical school and want to learn more about a career in surgery. The program will give these trainees one year of general surgery training before they go on to future graduate medical education.