The CRS resident is under the direct supervision of the program director and serves an intermediary role in the care of the colorectal surgery patients with responsibility and authority at a level between the attending surgeons and general surgery residents. Great importance is placed upon the need for preserving graded responsibility in the integrated training of the of the general surgery residents while enlarging the scope of responsibility of the CRS resident.
The CRS resident participates fully in the care of colorectal outpatients and is taught the diagnostic, therapeutic, endoscopic and surgical techniques suited to the care of these patients. Emphasis is placed upon the personal instruction of the resident in the outpatient office, at the bedside, in the operating room, and on teaching rounds. Attendance at departmental conferences is expected.
The CRS resident provides formal and informal lectures to the general surgery residents and medical students and serves as an academic role model. The CRS resident is strongly encouraged to participate in ongoing clinical and laboratory research and to author scientific publications. Formal scientific presentations at regional and national meetings are anticipated.
- Supervision of inpatient care regarding evaluation and diagnosis, treatment plan (including preoperative preparation and postoperative management as appropriate), discharge planning, and daily work rounds.
- Appropriate participation in surgical and endoscopic activities of the Division, with progressive responsibility.
- Interview and examination of new outpatients and inpatient consultations with development of a plan for diagnosis and management under supervision.
- Coordination of and participation in weekly teaching rounds.
- Attendance at departmental and interdepartmental conferences, including Morbidity and Mortality (weekly), Cancer Management Conference (weekly), GI Surgery Conference (weekly) and GI Multidisciplinary Conference (monthly).
- Selection and presentation of journal articles and topic reviews for the weekly Colorectal Surgery Fellows Conference. (Every other week is journal club alternating with a Powerpoint teaching conference according to the schedule provided at the beginning of the program.)
At the end of the Colorectal Surgery Residency the resident should be able to:
- Describe the embryology of the small intestine, colon, rectum, and anus.
- Describe the anatomy of the small intestine, colon, rectum and anus.
- Describe the physiology of the small intestine, colon, rectum and anus.
- Demonstrate understanding of the management of fluids and electrolytes in patients undergoing surgery of the small intestine, colon, rectum, and anus.
- Demonstrate understanding of applied pharmacology related to treatment of problems in the small intestine, colon, rectum and anus.
- Demonstrate understanding of bacteriology related to the small intestine, colon, rectum and anus.
- Demonstrate understanding of nutritional considerations in the management of diseases of the small intestine, colon, and rectum.
At the end of the Colorectal Surgery Residency the resident should be able to demonstrate proficiency in:
- Evaluating by clinical history and physical examination and prescribing treatment for patients with disorders of the lower gastrointestinal tract and anus.
- Evaluating and interpreting imaging studies of the bowel, including plain and contrast X-ray’s, CT and MRI scans, ultrasound studies, angiography and radionucleotide scintigraphy, defecography and PET scans.
- Planning and performing patient preparation prior to surgery and followup care of patients after surgery.
- Performing diagnostic and therapeutic endoscopies including anoscopy, rigid and flexible sigmoidoscopy, colonoscopy, polypectomy and stent placement.
- Performing anorectal surgery including common office procedures such as sclerotherapy, banding of hemorrhoids, excision of thromboses and drainage of abscesses.
- Performing colonic and small bowel surgery using open and minimally invasive techniques.
- Performing and evaluating anorectal physiology testing including defacography, intestinal transit studies, intrarectal ultrasound, anal manometry and biofeedback.
- Recogonizing and managing complications of colorectal diseases and surgery