Surgery Residency

NewYork-Presbyterian Queens

Education

Rotations

PGY-1

Acute Care and Trauma Surgery (Teams A GREEN and A RED)
General and Subspecialty Surgery (Teams B, D, E)
Vascular, Breast and Plastic Surgery (Team C)
Night Float
SICU
ER

PGY-2

Acute Care and Trauma Surgery (Teams A GREEN and A RED)
General and Subspecialty Surgery (Teams B, D, E)
Vascular, Breast and Plastic Surgery (Team C)
Thoracic Surgery
ER Consult
SICU
Abdominal Transplant (NYP/Columbia)

PGY-3

Acute Care and Trauma Surgery (Teams A GREEN and A RED)
General and Subspecialty Surgery (Teams B, D, E)
Vascular, Breast and Plastic Surgery (Team C)
Night Float
Thoracic Surgery

PGY-4

Acute Care and Trauma Surgery (Teams A GREEN and A RED)
General and Subspecialty Surgery (Teams B, D, E)
Vascular, Breast and Plastic Surgery (Team C)
Night Float Elective

PGY-5

Acute Care and Trauma Surgery (Teams A GREEN and A RED)
General and Subspecialty Surgery (Teams B, D, E)
Vascular, Breast and Plastic Surgery (Team C)
Administrative Chief

Rotation descriptions

Transplant

The four-week rotation to NewYork-Presbyterian/Columbia University Irving Medical Center focuses on the operative and critical care management of patients undergoing abdominal transplant including liver, kidney/pancreas, and small bowel transplant. Residents are afforded operative exposure to these technically challenging procedures as well as post-operative management, which provides an excellent review of the basic science of immunology. An added feature of the rotation is the resident's participation with teams that visit area hospitals for organ harvest. The NewYork-Presbyterian/Columbia University Irving Medical Center is a busy institution that receives patients referred from the entire eastern US.

Electives

PGY-4 year residents get to choose any surgical elective. All electives are to be approved by the program director.

General surgery

As in all residencies, the core experience for our trainees is in General Surgery. While recent years have seen a diminution in those procedures performed by the generalist, our residency is uniquely structured to educate truly well rounded and experienced practitioners. Surgical residents at NewYork-Presbyterian Queens are able to consider all procedure types "their own," and are limited in exposure only by their own interest.

No procedures, even the most sophisticated, are relegated to fellows, allowing general surgery residents to explore all areas into which their curiosity takes them. While many of our graduates go on to fellowships in the various specialties, others find themselves superbly prepared to practice the broadest type of surgery in places where subspecialists are few in number.

Surgical specialties

Surgical residents at NewYork-Presbyterian Queens have unique exposure to the surgical subspecialties. Each of the institution's subspecialty divisions are capable of the most sophisticated interventions and allof them perform large numbers of procedures with participation of general surgery residents. Because there are no fellows in any of the specialty areas, general surgery residents have full access to specialty patients, and indeed, are responsible for participation in their care.

Neurosurgery

In the ER and through associated didactics, the resident learns the routine assessment of the head-injured patient. In the SICU, the resident is exposed to the most seriously ill, brain-injured patients, and becomes knowledgeable in their pathophysiology and adept in their management.

Plastic surgery

The Plastic Surgery exposure is extensive for the interested resident. Residents become adept at grafting and are able to actively participate in more complex reconstructive procedures after trauma and tumor ablation. Residents performing cancer operations that are to be immediately reconstructed are encouraged to also participate in the restorative procedures that follow. The house staff will follow and care for these patients under the direction of both the ablative and the restorative surgeon.

Head and neck surgery

Experience in head and neck surgery is notable, with residents able to perform thyroid, parotid and oral surgery under the direction of experienced staff. Major operations for oropharyngeal cancers are commonly performed with the resident taught the principles of head and neck work up and the techniques of tumor extirpation and radical neck dissection.

Colorectal surgery

Resident experience in colorectal surgery is extensive at NewYork-Presbyterian Queens. The wealth of clinical material and the absence of fellows have made it possible for interested residents to perform as many as 100 colonic resections during their tenure here. Busy colorectal specialists instruct and supervise house staff in the latest techniques including nerve-sparing low anterior resections and laparoscopic colectomy.

Residents also become well versed in the ambulatory treatment of more common problems of the anal canal and transanal surgery. Rectal prolapse procedures, transanal cancer ablations, and treatment of rectovaginal fistulas are numerous.

Laparoscopic and robotic surgery

The education of today's future general surgeons must put a strong emphasis on laparoscopy. The Division of Minimally Invasive Surgery at NewYork-Presbyterian Queens specializes in this surgical approach. Within this division are surgeons who perform a number of minimally invasive operations.

As a prelude to clinical laparoscopy, Associate Program Director Joel Ricci-Gorbea, MD, takes each resident through a 6-week laparoscopy course which includes didactics, technical practice sessions, and animal laboratory work.

By the time residents finish their surgical training at NewYork-Presbyterian Queens, they have been exposed to the vast majority of operations that are currently performed laparoscopically. In addition to the broad exposure residents gain in the operating room, there is a 24-hour dedicated surgical skills laboratory, which contains a computerized laparoscopic curriculum as well as laparoscopic trainers to assist in mastering laparoscopic skills and training for the SAGES Fundamentals of Laparoscopic Surgery® exam. In addition, the surgical skills lab also contains a virtual endoscopy training system to help residents prepare for the SAGES Fundamentals in Endoscopic Surgery® exam. Finally, a da Vinci® robotic simulator is available for resident use, to gain proficiency at both general surgical and thoracic robotic procedures including abdominal and groin hernia repair, colorectal resection, and pulmonary, esophageal, and mediastinal surgery.

Thoracic surgery

Residents at NewYork-Presbyterian Queens participate in all thoracic procedures, with most of these performed by the residents under the tutelage of staff specialists. This rotation provides teaching leading to resident proficiency in mediastinal and esophageal resections, lung biopsy and blebectomy, decortication, and wedge, segmental, and lobar resections as well as pneumonectomy, via open, VATS and robotic approaches. The residents are also exposed to endobronchial ultrasound (EBUS) and endoscopic procedures.

Trauma surgery

Expertise in the care of the trauma patient is an important component of a general surgeon's armamentarium, and the trauma service provides the framework for our program to build upon. From the PGY-1 year onward through a process of supervised and graded responsibility, our surgical residents become facile and familiar with all aspects of the initial triage, resuscitation and management of the multiply injured and critically ill patient.

Caring for trauma patients requires an understanding of the pathophysiology of many organ systems and an ability to triage each system in the treatment process. It also provides the senior resident opportunity to be "captain of the ship;" acting as the coordinator of care provided by disparate subspecialties.

The training program at the NewYork-Presbyterian Queens provides an excellent background for the trauma service. There are no residency programs in the surgical subspecialties, and as a result, our residents may add to their general surgical prowess an understanding of the pathophysiology and treatment of surgical conditions within subspecialty areas such as thoracic, peripheral vascular, urologic, plastic and neurosurgery. This provides a basis for excellent communication between the members of the trauma team and prevents fragmentation of care among various subspecialty support groups.