Resident Experience | General Surgery Residency | Residents & Fellows | Dartmouth-Hitchcock
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Resident Experience

The Department of Surgery offers both preliminary and categorical training programs in General Surgery, using the combined facilities of the Mary Hitchcock Memorial Hospital (MHMH) in Lebanon, NH, and the Veterans Administration Medical Center (VAMC) in nearby White River Junction, VT.

Clinical Experience

PGY-1

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

  • Breast Disease/Surgical Oncology
  • Thoracic Surgery
  • Emergency Department
  • Colorectal Surgery and Transplantation Surgery
  • General Surgery (VAMC)
  • Intensive Care Unit
  • Otolaryngology
  • Plastic Surgery
  • Trauma Surgery
  • Night Emergency Trauma
  • Urology
  • Vascular Surgery

PGY-2

The first two 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 two-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 six two-month rotations on these services:

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

PGY-3

The four 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 four three month rotations on these services:

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

Depending on funding sources, the opportunity for one or two 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 four Surgical Services at Dartmouth-Hitchcock. In addition, residents will be provided additional exposure to Transplant, Vascular and Thoracic Surgery.

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

PGY-5

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

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

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

*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.

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 7am 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 anastamosis) in the Patient Safety and Training Center. Residents have 24/7 access to this facility for individual development.

Chairman's Rounds

Beginning this academic year, the Surgery Department Chairman, Dr. Sandra Wong, will meet with residents to discuss topics such as “The Business of Medicine”, “How to Create a CV”, “How to apply for fellowships” and “How to Conduct Research” will be presented during the Friday morning resident protected education time. This time also serves as an opportunity for residents to get updates about the program and give input for future changes.

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

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

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.

2017

2015-2016

  • Bostock IC1, Zarkowsky DS1, Hicks CW2, Stone DH1, Eslami MH3, Malas MB2, Goodney PP1.
    Am J Transplant. 2016 Aug;16(8):2395-400. doi: 10.1111/ajt.13733. Epub 2016 Mar 31. Outcomes of Endovascular Aortic Aneurysm Repair in Kidney Transplant Recipients: Results From a National Quality Initiative.
  • Ivatury SJ1, Bostock Rosenzweig IC, Holubar SD.Dis Colon Rectum. 2016 Jun;59(6):543-50. doi: 10.1097/DCR.0000000000000581. Short-term Outcomes After Open and Laparoscopic Colostomy Creation.
  • Fallon JM1, Axelrod DA2. J Card Fail. 2016 Mar;22(3):238-9. doi: 10.1016/j.cardfail.2016.01.003. Epub 2016 Jan 14. LVAD Volume-Outcome Relationship: Surgeon, Center, or Both?
  • Fallon JM1, Goodney PP2, Stone DH2, Patel VI3, Nolan BW2, Kalish JA4, Zhao Y2, J Vasc Surg. 2015 Nov;62(5):1183-91.e1. doi: 10.1016/j.jvs.2015.06.203. Epub 2015 Aug 5. Outcomes of lower extremity revascularization among the hemodialysis-dependent. Vascular Study Group of New England.
  • Wallaert JB1, Newhall KA2, Suckow BD2, Brooke BS3, Zhang M4, Farber AE5, Likosky D6, Goodney PP2;
    Ann Vasc Surg. 2016 May 26. pii: S0890-5096(16)30338-7. doi: 10.1016/j.avsg.2016.01.024. [Epub ahead of print] Relationships between 2-Year Survival, Costs, and Outcomes following Carotid Endarterectomy in Asymptomatic Patients in the Vascular Quality Initiative.
    Vascular Quality Initiative.
  • Newhall KA1, Bekelis K2, Suckow BD3, Gottlieb DJ4, Farber AE4, Goodney PP5, Skinner JS4.
    Vascular. 2016 May 19. pii: 1708538116650099. [Epub ahead of print] The relationship of regional hemoglobin A1c testing and amputation rate among patients with diabetes.
  • Newhall KA1, Saunders EC2, Larson RJ3, Stone DH4, Goodney PP5. JAMA Surg. 2016 Mar;151(3):247-55. doi: 10.1001/jamasurg.2015.3592. Use of Protamine for Anticoagulation During Carotid Endarterectomy: A Meta-analysis.
  • Kang R1, Goodney PP1, Wong SL1. J Surg Oncol. 2016 Sep;114(3):275-80. doi: 10.1002/jso.24331. Epub 2016 Jun 22. Importance of cost-effectiveness and value in cancer care and healthcare policy.
  • Cook MR1, Louis SG2, McCully SP2, Stucke RS2, Fabricant SP2, Schreiber MA2. Injury. 2015 Jan;46(1):131-5. doi: 10.1016/j.injury.2014.09.017. Epub 2014 Oct 2. Positive blood alcohol is associated with reduced DVT in trauma.
  • Louie RJ, Tonneson JE, Gowarty M, Goodney PP, Barth RJ Jr, Rosenkranz KM.
    Breast Cancer Res Treat. 2015 Nov;154(1):99-103. Complete blood counts, liver function tests, and chest x-rays as routine screening in early-stage breast cancer: value added or just cost?
  • Zhao T1, Mejaddam AY, Chang Y, DeMoya MA, King DR, Yeh DD, Kaafarani HM, Alam HB, Velmahos GC.
    J Trauma Acute Care Surg. 2016 Oct;81(4):743-747.
    Admissions for isolated nonoperative mild head injuries: Sharing the burden among trauma surgery, neurosurgery, and neurology.
  • Peponis T1, Cropano MC1, Larentzakis A1, van der Wilden MG1, Mejaddam YA1, Sideris CA1, Michailidou M1, Fikry K1, Bramos A1, Janjua S1, Chang Y1,King DR2. Eur J Trauma Emerg Surg. 2016 Mar 19. [Epub ahead of print] Trauma team utilization of universal precautions: if you see something, say something.
  • Mavros MN1, Kaafarani HM1, Mejaddam AY1, Ramly EP1, Avery L2, Fagenholz PJ1, Yeh DD1, de Moya MA1, Velmahos GC3,4. World J Surg. 2015 Nov;39(11):2685-90. doi: 10.1007/s00268-015-3182-6.
    Additional Imaging in Alert Trauma Patients with Cervical Spine Tenderness and a Negative Computed Tomographic Scan: Is it Needed?
  • Sheikh F1, Akinkuotu A1, Clark SJ1, Zamora IJ1, Cass DL1, Olutoye O1, Lee TC2.
    J Pediatr Surg. 2016 Apr;51(4):545-8. doi: 10.1016/j.jpedsurg.2015.11.006. Epub 2015 Dec 1.
    Assessment of quality of life outcomes using the pediatric quality of life inventory survey in prenatally diagnosed congenital diaphragmatic hernia patients.
  • Olutoye OA1, Sheikh F2, Zamora IJ2, Yu L2, Akinkuotu AC2, Adesina AM3, Olutoye OO4.
    Am J Obstet Gynecol. 2016 Apr;214(4):542.e1-8. doi: 10.1016/j.ajog.2015.10.927. Epub 2015 Nov 4.
    Repeated isoflurane exposure and neuroapoptosis in the midgestation fetal sheep brain.
  • Akinkuotu AC1, Nuthakki S2, Sheikh F1, Cruz SM1, Welty SE2, Olutoye OO3.Am J Surg. 2015 Dec;210(6):1045-9; discussion 1049-50. doi: 10.1016/j.amjsurg.2015.08.004. Epub 2015 Sep 14.
    The effect of supplemental parenteral nutrition on outcomes of necrotizing enterocolitis in premature, low birth weight neonates.
  • Singh S1, Stroud AM, Holubar SD, Sandborn WJ, Pardi DS. Cochrane Database Syst Rev. 2015 Nov 23;(11):CD001176. doi: 10.1002/14651858.CD001176.pub3. Treatment and prevention of pouchitis after ileal pouch-anal anastomosis for chronic ulcerative colitis.
  • Stroud AM1, Parker D2, Croitoru DP3. J Pediatr Surg. 2016 May;51(5):853-8. doi: 10.1016/j.jpedsurg.2016.02.036. Epub 2016 Feb 13. Timing of bariatric surgery for severely obese adolescents: a Markov decision-analysis.
  • Munch JL1, Zusman NL1, Lieberman EG1, Stucke RS1, Bell C1, Philipp TC1, Smith S1, Ching AC1, Hart RA1, Yoo JU2Spine J. 2016 Jun;16(6):694-9. doi: 10.1016/j.spinee.2015.07.442. Epub 2015 Aug 4.
    A scoring system to predict postoperative medical complications in high-risk patients undergoing elective thoracic and lumbar arthrodesis.
  • Hicks CW1, Canner JK1, Zarkowsky DS2, Arhuidese I1, Obeid T1, Malas MB3.
    J Vasc Surg. 2016 Mar 15. pii: S0741-5214(16)00188-9. doi: 10.1016/j.jvs.2016.01.049. [Epub ahead of print]
    Racial disparities after vascular trauma are age-dependent.
  • Zarkowsky DS1, Hicks CW2, Malas MB2. JAMA Surg. 2016 Jul 1;151(7):687. doi: 10.1001/jamasurg.2015.5559.
    One-Third of Patients in a National Cohort Initiating Hemodialysis With a Catheter Despite 6 Months of Nephrology Care.

Extracurricular Activities

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

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