Resident Experience

The Department of Surgery offers both preliminary and categorical training programs in General Surgery, using the combined facilities of the Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, and the Veterans Administration Medical Center (VAMC) in nearby White River Junction, Vermont.

Clinical experience

PGY-1

The first year consists of 12 one-month rotations on these services:

  • Colorectal Surgery
  • Community Surgery
  • General Surgery (VAMC)
  • Intensive Care Unit
  • Night Emergency Trauma
  • Palliative Care
  • Robotics
  • Surgical Oncology
  • Thoracic Surgery
  • Transplantation Surgery
  • Trauma Surgery
  • Vascular Surgery

PGY-2

The first 2 years of the program are designed to give each resident the basis for a final choice in a surgical career and a foundation of knowledge and experience upon which to build subsequent training. It is expected that upon completion of this 2-year core, residents will have acquired considerable skill and confidence in the management of critically ill patients and facility in basic surgical techniques.

The second year consists of 6 two-month rotations on these services:

  • Colorectal Surgery
  • General Surgery-Community-Based (Concord)
  • General Surgery-Laparoscopic
  • Intensive Care Unit
  • Minimally Invasive Surgery
  • Night Emergency Trauma
  • Trauma and Acute Care Surgery

PGY-3

The 4 residents continuing in the five-year General Surgery Program receive training in Pediatric Surgery in addition to extensive exposure to the traditional areas of General Surgery, including endoscopy and colorectal surgery.

The third year consists of 4 three-month rotations on these services:

  • Breast Disease/Surgical Oncology
  • General Surgery Veterans Affairs Medical Center (VAMC)
  • General Surgery-Community-based (Concord)
  • Pediatric Surgery

Depending on funding sources, the opportunity for 1 or 3 years of full-time research is offered following the third year of the General Surgery Program. Re-entry at the fourth-year level is provided following the completion of the research period.

PGY-4

In the fourth year, the Senior Residents assume responsibility for the day-to-day management of the inpatient services of several attending physicians on each of the 4 Surgical Services at Dartmouth Hitchcock Medical Center. In addition, residents will be provided additional exposure to Transplant, Vascular and Thoracic Surgery.

  • Colorectal Surgery
  • Community Surgery
  • General Surgery Community
  • Minimally Invasive Surgery
  • Night Emergency Trauma
  • Thoracic Surgery
  • Transplant Surgery

PGY-5

During the fifth year of the program, the 4 Chief Residents have responsibility for:

  • General Surgery
  • General Surgery Breast Disease/Surgical Oncology
  • General Surgery Consult (Trauma) Service
  • General Surgery/Transplant Program/Colorectal Surgery

In addition to an elective practice of variety and substance, the Chief Residents virtually manage all urgent and trauma problems in the Center. The three-month rotations cover:

  • Breast Disease/Surgical Oncology
  • Flex Time*
  • General Surgery-Consult (Trauma)
  • General Surgery-Transplant/Colorectal

*Flex time will be provided during the fifth year to allow chief residents increased time in a resident's selected area of interest.

Didactics

Resident education is a core focus of our program at Dartmouth Hitchcock Medical Center.

Each service holds a variety of educational sessions throughout the week ranging from preoperative conferences to interdisciplinary tumor boards. On Friday mornings residents have protected time from 7:00am to noon to attend formal lectures. Below is a description of conferences available to residents during this time.

Morbidity and Mortality Conference

Presented by residents each week.

Grand Rounds

Presented by guest lecturers, visiting professors, or faculty from the Department of Surgery including subspecialty divisions.

Clinical and Basic Science Lectures

Divided into junior and senior resident sessions. Clinical and Basic Science lectures are combined for juniors and seniors:

  • PGY-1 and 2 residents didactics are based on a question based review of the Washington Manual for Surgery
  • PGY-3, 4, and 5 residents follow the SCORE curriculum
  • Both sessions are facilitated by faculty with emphasis on discussion and avoiding a lecture format

Simulation Lab

A robust simulation experience with dedicated time on Friday mornings free of clinical activity has been ongoing for several years. This provides the opportunity to practice surgical skills including FLS and FES training and open surgical technique (such as vascular and GI anastomosis) in the Patient Safety and Training Center. Residents have 24/7 access to this facility for individual development.

Journal Club

Monthly meeting where selected articles in current surgical journals are discussed. Provides a forum to discuss advances in surgery and develop a systematic approach to critical evaluation of the literature. Discussions are facilitated by faculty, but are often resident-driven.

Oral Board Examinations

PGY residents at the 3 to 5 level are given oral exams by the staff monthly. Junior residents and attending staff are present to learn and to provide feedback on performance to help prepare the residents to sit for the ABS Board Examinations.

Research

Surgical Trainee Research Initiative and Evaluation (STRIVE) Program

The Department of Surgery launched the Surgical Trainee Research Initiative and Evaluation (STRIVE) Program in 2016 to support surgical research residents in pursuing their research goals. The program was developed by Kayla Moore and Dr. Philip Goodney based on findings from a participatory needs assessment conducted in April 2016 and responds to needs identified by prior year research residents and department leaders.

Learn more about STRIVE.

Publications

See the lists below to learn about resident abstracts and publications, 2015 to present.

2019-2020

  • Wilcox AR, Lai CS, Stanzah FE, Farrar JG, Trooboff SW, Turner PL, Wong SL.
    Gender Representation by Specialty Track at Surgical Meetings: The American and Australasian Experiences.
    JSR. 2020 9;253:149-155. doi: 10.1016/j.jss.2020.03.045
  • Wilcox AR, Trooboff SW, Lai CS, Turner PL, Wong SL.
    Trends in Gender Representation at the American College of Surgeons Clinical Congress and the Academic Surgical Congress: A Mixed Picture of Progress.
    JACS. 2019 Oct;10(4):397-403. doi: 10.1016/j.jamcollsurg.2019.06.002
  • Wilcox AR, Trooboff SW, Wong SL.
    Evaluating Patient-Reported Outcomes in Inguinal Hernia Clinical Trials.
    Feature article: JSR. 2019 Dec;244:430-435. doi: doi.org/10.1016/j.jss.2019.06.055
  • Sacks OA, Lambour AJ, Wilcox AR, Nammalwar S, Wong SL.
    Quality assessment of the literature on surgical quality improvement.
    Surgery. 2019 Nov;166(5):764-768. doi: 10.1016/j.surg.2019.05.016
  • Merali N, Wilcox AR, Croitoru DP, Baertschiger RM.
    Infantile Hypertrophic Pyloric Stenosis Following Repair of H-type Tracheoesophageal Fistula Repair and Post-operative Erythromycin Therapy.
    Journal of Neonatal Surgery. 2019 Jan;8(1):7. doi.org/10.21699/jns.v8i1.848
  • Mejaddam AY, Hornick MA, McGovern PE, et al.
    Fetal Diagn Ther. 2019;46(4):231-237.
    Erythropoietin Prevents Anemia and Transfusions in Extremely Premature Lambs Supported by an EXTrauterine Environment for Neonatal Development (EXTEND).
  • Goldwag J, Lyn R, Wilson L, Wilson M, and Ivatury S.
    Effect of Elective Sigmoidectomy for Diverticulitis on Bowel Function Patient-Reported Outcomes.
    J Surg Res. 2019 Apr 22; 241:135-140. Doi: 10.1016/j.jss.2019.03.041
  • Goldwag J, Marsicovetere P, Scalia P, Johnson H, Durand MA, Elwyn G, and Ivatury S.
    The impact of decision aids in patients with colorectal cancer: a systematic review.
    BMJ Open. 2019 Sep 12; 9:e028379. Doi: 10.1136/bmjopen-2018-028379
  • Goldwag J, and Jung S.
    Operating Room Preparation by General Surgery Residents: A qualitative analysis.
    Am J Surg. 2019 Dec 20; pii: S0002-9610(19)31572-7. doi: 10.1016/j.amjsurg.2019.12.020
  • Goldwag J, Wilson L, Ivatury S, Tsapakos M, and Wilson M.
    The Prevalence of Fascial Defects at Prior Stoma Sites in Patients with Colorectal Cancer.
    IJAWHS. 2020; Doi: 10.4103/ijawhs.ijawhs_56_19
  • Goldwag J, Panitz A, and Pinto-Powell R.
    Medical Student Involvement on Admission Committees.
    Med Sci educ. 2020 March 23. Doi:10.1007/s40670-020-00950-z
  • Goldwag J, Wilson L, Ivatury S, Pauli E, Tsapakos M, and Wilson M.
    Stoma Closure and Reinforcement (SCAR): A study protocol for a pilot trial.
    Contemp Clin Trials Commun. 2020, June 9 DOI: 10.1016/j.conctc.2020.100582
  • Goldwag J, Porter E, Wilcox A, Martin E, Wolffing A, Mancini D, Briggs A.
    Geriatric ATV and Snowmobile Trauma at a Rural Level 1 Trauma Center: A Blow to the Chest.
    Injury, 2020, June 17. DOI: 10.1016/j.injury.2020.05.043
  • Kang R, Read JT, Glaser AC, Barth RJ Jr.
    Eliminating Opioids from Breast Conserving Surgery: Perioperative Pain Management Pathway.
    J Am Coll Surg. 2020 Jun;230(6):975-982. doi: 10.1016/j.jamcollsurg.2020.03.025. PMID: 32451057.
  • Columbo JA, Ramkumar N, Martinez-Camblor P, Kang R, Suckow BD, O'Malley AJ, Sedrakyan A, Goodney PP.
    Five-year reintervention after endovascular abdominal aortic aneurysm repair in the Vascular Quality Initiative.
    J Vasc Surg. 2020 Mar;71(3):799-805.e1. doi: 10.1016/j.jvs.2019.05.057. Epub 2019 Aug 27. PMID: 31471231; PMCID: PMC7042040.
  • Anderson PB, Wanken ZJ, Perri JL, Columbo JA, Kang R, Spangler EL, Newhall K, Brooke BS, Dosluoglu H, Lee ES, Raffetto JD, Henke PK, Tang GL, Mureebe L, Kougias P, Johanning J, Arya S, Scali ST, Stone DH, Suckow BD, Orion K, Halpern V, O'Connell J, Inhat D, Nelson P, Tzeng E, Zhou W, Barry M, Sirovich B, Goodney PP; PROVE-AAA Study Team.
    Patient information sources when facing repair of abdominal aortic aneurysm.
    J Vasc Surg. 2020 Feb;71(2):497-504. doi: 10.1016/j.jvs.2019.04.460. Epub 2019 Jul 26. PMID: 31353272.
  • Columbo JA, Kang R, Spangler EL, Newhall K, Brooke BS, Dosluoglu H, Lee ES, Raffetto JD, Henke PK, Tang GS, Mureebe L, Kougias P, Johanning J, Arya S, Scali ST, Stone DH, Suckow BD, Orion K, Halpern V, O'Connell J, Inhat D, Nelson P, Tzeng E, Zhou W, Barry M, Sirovich B, Goodney PP;
    PROVE-AAA Study Team. Design of the PReferences for Open Versus Endovascular Repair of Abdominal Aortic Aneurysm (PROVE-AAA) Trial.
    Ann Vasc Surg. 2020 May;65:247-253. doi: 10.1016/j.avsg.2019.02.034. Epub 2019 May 8. PMID: 31075459.
  • Columbo JA, Sedrakyan A, Mao J, Hoel AW, Trooboff SW, Kang R, Brown JR, Goodney PP.
    Claims-based surveillance for reintervention after endovascular aneurysm repair among non-Medicare patients.
    J Vasc Surg. 2019 Sep;70(3):741-747. doi: 10.1016/j.jvs.2018.11.031. Epub 2019 Mar 25. PMID: 30922744; PMCID: PMC6708752.
  • Leinweber KA, Columbo JA, Kang R, Trooboff SW, Goodney PP.
    A Review of Decision Aids for Patients Considering More Than One Type of Invasive Treatment.
    J Surg Res. 2019 Mar;235:350-366. doi: 10.1016/j.jss.2018.09.017. Epub 2018 Nov 13. PMID: 30691817.
  • Kang R, Kunkel ST, Columbo JA, Goodney PP, Wong SL.
    Association of Hospital Employee Satisfaction with Patient Safety and Satisfaction within Veterans Affairs Medical Centers.
    Am J Med. 2019 Apr;132(4):530-534.e1. doi: 10.1016/j.amjmed.2018.11.031. Epub 2018 Dec 20. PMID: 30579740.
  • Kang R, Columbo JA, Trooboff SW, Servos MM, Goodney PP, Wong SL.
    Receipt of sentinel lymph node biopsy for thin melanoma is associated with distance traveled for care.
    J Surg Oncol. 2019 Jan;119(1):148-155. doi: 10.1002/jso.25314. Epub 2018 Dec 3. PMID: 30508289.
  • Kang R, Seath BE, Huang V, Barth RJ Jr.
    Impact of Autologous Blood Transfusion on Survival and Recurrence among Patients Undergoing Partial Hepatectomy for Colorectal Cancer Liver Metastases.
    J Am Coll Surg. 2019 Jun;228(6):902-908. doi: 10.1016/j.jamcollsurg.2018.10.020. Epub 2018 Nov 16. PMID: 30448300.
  • Columbo JA, Kang R, Hoel AW, Kang J, Leinweber KA, Tauber KS, Hila R, Ramkumar N, Sedrakyan A, Goodney PP.
    A comparison of reintervention rates after endovascular aneurysm repair between the Vascular Quality Initiative registry, Medicare claims, and chart review.
    J Vasc Surg. 2019 Jan;69(1):74-79.e6. doi: 10.1016/j.jvs.2018.03.423. Epub 2018 Jun 15. PMID: 29914838; PMCID: PMC6481637.
  • Columbo JA, Martinez-Camblor P, MacKenzie TA, Kang R, Trooboff SW, Goodney PP, O'Malley AJ.
    A comparative analysis of long-term mortality after carotid endarterectomy and carotid stenting.
    J Vasc Surg. 2019 Jan;69(1):104-109. doi: 10.1016/j.jvs.2018.03.432. Epub 2018 Jun 15. PMID: 29914828; PMCID: PMC6295272.

2018

  • Bostock IC1, Zarkowsky DS2, Hicks CW3, Stone DH4, Malas MB3, Goodney PP4.
    Ann Vasc Surg. 2018 Jul;50:167-172. doi: 10.1016/j.avsg.2017.11.063. Epub 2018 Feb 23.
    Outcomes and Risk Factors Associated with Prolonged Intubation after EVAR.
  • Iribarne A1,2, Easterwood RM3, Bostock IC1, McCullough JN1.
    J Thorac Dis. 2017 Oct;9(10):3529-3532. doi: 10.21037/jtd.2017.09.16.
    Outcomes with moderate aortic stenosis and impaired left ventricular function: prelude to a randomized trial?
  • Bostock IC1, Hill MV1, Counihan TC1, Ivatury SJ2.
    J Surg Res. 2018 Jan;221:167-172. doi: 10.1016/j.jss.2017.08.030. Epub 2017 Sep 23.
    Mortality after emergency Hartmann's procedure in octogenarians: a propensity score-matched analysis.
  • Beijert I1,2, Mert S1, Huang V1, Karimian N1, Geerts S1, Hafiz EOA1,3, Markmann JF4, Yeh H4, Porte RJ2, Uygun K1.
    Transplant Direct. 2018 Apr 23;4(5):e345. doi: 10.1097/TXD.0000000000000779. eCollection 2018 May.
    Endothelial Dysfunction in Steatotic Human Donor Livers: A Pilot Study of the Underlying Mechanism During Subnormothermic Machine Perfusion.
  • Columbo JA1, Kang R2, Hoel AW3, Kang J4, Leinweber KA5, Tauber KS5, Hila R5, Ramkumar N6, Sedrakyan A7, Goodney PP8.
    J Vasc Surg. 2018 Jun 15. pii: S0741-5214(18)30916-9. doi: 10.1016/j.jvs.2018.03.423. [Epub ahead of print]
    A comparison of reintervention rates after endovascular aneurysm repair between the Vascular Quality Initiative registry, Medicare claims, and chart review.
  • Columbo JA1, Martinez-Camblor P2, MacKenzie TA3, Kang R2, Trooboff SW2, Goodney PP4, O'Malley AJ3.
    J Vasc Surg. 2018 Jun 15. pii: S0741-5214(18)31015-2. doi: 10.1016/j.jvs.2018.03.432. [Epub ahead of print]
    A comparative analysis of long-term mortality after carotid endarterectomy and carotid stenting.
  • Columbo JA1,2,3,4, Davies L2,3, Kang R2,3,4, Barnes JA1, Leinweber KA4, Suckow BD1,4, Goodney PP1,3,4, Stone DH1,4.
    Vasc Endovascular Surg. 2018 May;52(4):262-268. doi: 10.1177/1538574418761984. Epub 2018 Mar 1.
    Patient Experience of Recovery After Major Leg Amputation for Arterial Disease.
  • Hornick MA1, Davey MG1, Partridge EA1, Mejaddam AY1, McGovern PE1, Olive AM1, Hwang G1, Kim J1, Castillo O1, Young K1, Han J1, Zhao S1, Connelly JT2, Dysart KC2, Rychik J3, Peranteau WH1, Flake AW1.
    J Physiol. 2018 May 1;596(9):1575-1585. doi: 10.1113/JP275367. Epub 2018 Mar 2.
    Umbilical cannulation optimizes circuit flows in premature lambs supported by the EXTra-uterine Environment for Neonatal Development (EXTEND).
  • Peponis T1, Bohnen JD, Muse S, Fuentes E, van der Wilden GM, Mejaddam A, Alam H, Kaafarani HMA, Fagenholz PJ, King DR, Yeh DD, Velmahos GC, de Moya MA.
    J Trauma Acute Care Surg. 2018 May 4. doi: 10.1097/TA.0000000000001970. [Epub ahead of print]
    Interrupted Versus Continuous Fascial Closure in Patients Undergoing Emergent Laparotomy: A Randomized Controlled Trial.
  • Rossidis AC, Baumgarten HD, Lawrence KM, McGovern PE, Mejaddam AY, Li H, Hwang G, Young K, Peranteau WH, Davey MG, Gaynor JW, Flake AW.
    Fetal Diagn Ther. 2018 Jun 28:1-8. doi: 10.1159/000488283. [Epub ahead of print]
    Chronically Hypoxic Fetal Lambs Supported by an Extra-Uterine Device Exhibit Mitochondrial Dysfunction and Elevations of Hypoxia Inducible Factor 1-Alpha.
  • Call L1, Stoll B1, Oosterloo B1, Ajami N2, Sheikh F3, Wittke A4, Waworuntu R4, Berg B4, Petrosino J2, Olutoye O3, Burrin D5.
    Microbiome. 2018 Jun 19;6(1):111. doi: 10.1186/s40168-018-0498-0.
    Metabolomic signatures distinguish the impact of formula carbohydrates on disease outcome in a preterm piglet model of NEC.
  • Hill MV1, Stucke RS1, Billmeier SE1, Kelly JL1, Barth RJ Jr2.
    J Am Coll Surg. 2018 Jun;226(6):996-1003. doi: 10.1016/j.jamcollsurg.2017.10.012. Epub 2017 Nov 30.
    Guideline for Discharge Opioid Prescriptions after Inpatient General Surgical Procedures.
  • Kang R1, Columbo JA2, Kunkel ST3, Stucke RS4, Sabatino MJ3, Tang A5, Goodney PP2, Rosenkranz KM4.
    J Am Coll Surg. 2018 Jun;226(6):1036-1043. doi: 10.1016/j.jamcollsurg.2017.11.019. Epub 2017 Dec 7.
    Residents' Impressions of the Impact of Advanced Practice Providers on Surgical Training.
  • Columbo JA1, Martinez-Camblor P2, MacKenzie TA3, Kang R2, Trooboff SW2, Goodney PP4, O'Malley AJ3.
    J Vasc Surg. 2018 Jun 15. pii: S0741-5214(18)31015-2. doi: 10.1016/j.jvs.2018.03.432. [Epub ahead of print]
    A comparative analysis of long-term mortality after carotid endarterectomy and carotid stenting.
  • Wilcox AR1,2, Wong SL3,4.
    Ann Surg Oncol. 2018 Jul;25(7):1801-1802. doi: 10.1245/s10434-018-6500-z. Epub 2018 May 3.
    Changing the Status Quo, Including How We Measure It.

Extracurricular Activities

General Surgery residents are involved in a number of community and hospital activities, including:

  • Dartmouth Hitchcock Medical Center Ethics committee and clinical consultation subcommittee member
  • Junior faculty at Harvard Medical School in Medical Ethics
  • Small group leader, Biostatistics, Geisel School of Medicine at Dartmouth
  • Teaching Assistant, Epidemiology and Biostatistics, The Dartmouth Institute