The integrated PGY-1 year encompasses time in Surgery and Urology. There are 13 4-week rotations incorporating 8 to 9 rotations of general surgery and surgical specialties and 3 to 4 rotations of urology. This schedule is coordinated with the general surgery program to ensure an adequate base of the care of surgical patients can be obtained.
Sample rotations for PGY-1
|VA Surgery||Colorectal||ICU||Gen Surg
|Plastic Surgery||Gen Surgery
|DHMC Junior||Elective/Research||VAMC Chief Resident||DHMC A Urologic Oncology and Laparoscopy|
|DHMC Transplant Urology / CHaD Pediatric Urology||DHMC A Urologic Oncology and Laparoscopy||Concord Hospital Urology||DHMC B General Urology, Endourology, and Female Urology|
|DHMC Junior||VAMC||DHMC Senior||DHMC Chief Resident|
|DHMC Transplant Urology/Pediatric Urology||DHMC B General Urology, Endourology, and Female Urology||Concord Hospital Urology||DHMC Chief Resident|
Listed below is a general overview of each year. The skills, objectives and responsibilities of each year of the residency are published in Med-Hub and distributed at the beginning of the year and prior to each rotation.
Second-year residents rotate through all of the 3 clinical services at Dartmouth Hitchcock Medical Center (DHMC). Continuity of care occurs by seeing new patients in clinic, operating on and caring for the same patient post-op, and then seeing patients return to clinic for follow-up. Every 3 months they rotate to another team. During the pediatric block, residents also participate with the transplant team. While assigned to a particular team, residents attend clinic and operate with the team's attending’s.
During the pediatric urology block, the resident spends a half-day per week going to transplant clinic, where they are involved in the workup of new patients and the follow-up of patients on whom they have operated. They participate in donor nephrectomy and in transplantation, particularly the neocystotomy.
Third-year residents rotate through both adult urology services at Dartmouth Hitchcock Medical Center for 3 months each, rotate at the VA for 3 months, and have a 3 month elective block. Electives have typically included protected block for supervised research, although other electives at approved sites may be pursued after discussion with the program director. Electives could consist of Men's Health, radiation oncology, interventional radiology, FPMRS with Gyn, or other rotations.
During the 3 month rotation at the VA, residents oversee the inpatient and outpatient urology service there. As in other locations, care is taken to ensure that continuity of care occurs by having the resident see patient in the ER or as consults, in addition to operating. An overarching goal is for the resident to gain additional expertise in a private-practice setting in both inpatient and outpatient care at a VA medical center.
Fourth-year residents rotate in pediatrics and transplant, at the VA, in Concord, and as the senior resident at Dartmouth Hitchcock Medical Center. As before, the resident has increased responsibility assigned to them each time they rotate on a service.
While assigned to a particular team, residents attend clinic and operate with the attending’s. Continuity of care occurs by seeing new patients in clinic, operating on patients and caring for them post-op, and then seeing patients return to clinic for follow-up.
Residents spend 3 months at the VA, overseeing the inpatient and outpatient urology service there. The resident is the operating surgeon under supervision on all cases. Fourth year residents do a 6 month rotation in Concord, where they work with 9 attending’s. As in other locations, care is taken to ensure that continuity of care occurs by having the resident see patient in the ER or as consults, in addition to operating.
Fifth year: Chief Resident
Fifth-year residents rotate at Dartmouth Hitchcock Medical Center for 12 months, with 6 months as the administrative chief resident. Attending’s give the chief resident increased responsibility in caring for patients. The administrative chief resident is responsible for the entire service. Although residents may be assigned to teams during certain rotations, the chief resident will oversee the assignment of cases to ensure that cases are assigned to an appropriate-level resident while still allowing junior residents to have some participation in complex cases.
The resident is ideally the operating surgeon under supervision on the most complex cases. Continuity of care occurs by seeing new patients in clinic, operating on patients and caring for them post-op, and then seeing patients return to clinic for follow-up.