Allegheny General is recognized as one of the nation's leading hospitals, with particular excellence in cancer care, cardiac care, orthopaedics, neurosciences and trauma.

General Surgery Residency Program
The five-year General Surgery Residency Program provides an academic setting strongly weighted in clinical experience. The program is accredited by the Residency Review Committee of Surgery and is one of Allegheny General's accredited residencies. The program's primary goal is to prepare residents to function as independent and highly qualified practitioners of surgery. During the past five years, more than 85 percent of the residents have passed their surgical Boards on the first try. Over the past five years, about two-thirds of our graduates chose to do a fellowship and one-third of our graduates began to practice general surgery following their residency training.

The General Surgery Residency Program is enhanced by areas of concentration, including trauma/critical care, surgical oncology, colon and rectal surgery, vascular surgery, cardiothoracic surgery, hepatobiliary surgery and both basic and advanced laparoscopic surgery. Surgical residents see patients in the surgical ambulatory care area and in faculty surgeons' private offices.

The General Surgery Residency Program is based at Allegheny General Hospital. There are 24 main operating rooms, including an integrated minimally invasive suite, four obstetrics and gynecology operating rooms and seven operating rooms in the ambulatory surgery center. There is a 24-bed surgical/trauma intensive care unit, 16-bed cardiothoracic intensive care unit and a 19-bed neurosurgical intensive care unit.

For over 25 years, Allegheny General Hospital has been designated as a Level I Regional Resource Center for Trauma. Annual admissions are 2,750 with over 2,000 of those cases admitted to the Division of Trauma Surgery. The staff of the 24-bed Trauma Surgical Intensive Care Unit provides critical care services to 800 trauma patients annually. LifeFlight, introduced in 1978, was the first aeromedical emergency transport system in the northeastern United States. Five LifeFlight helicopters transport more than 200 patients per month within a 150-mile radius of Pittsburgh. Allegheny General Hospital was also the first in the Commonwealth to open its own dedicated trauma intensive care unit. The emergency room cares for 45,000 patients annually. In the emergency room, there are 31 examination/treatment rooms, including five trauma resuscitation bays and a CT scanner within the department. The trauma intensive care unit is adjacent to the emergency room.

Core Curriculum
The general surgical rotations are organized to provide each resident an opportunity to learn preoperative and outpatient care. On most services, an average of one day per week is devoted to the outpatient clinics. They also learn operative management, and postoperative care, including intensive care unit management. Each surgical service is organized as a team of one or more attending surgeons, a senior or Chief resident and one or more junior residents. Attending surgeons supervise the care of each patient on each service and talk or round with the residents daily, including weekends and holidays. Under this arrangement, the residents are closely supervised, but allowed increased responsibility and autonomy in the care of patients as they advance to the Chief year. The goal of the Chief Resident is to graduate as an independent, highly-competent, skilled, and confident operating surgeon. On each service, residents are expected to learn patient care, medical knowledge, interpersonal and communication skills, and professionalism.

General Surgery Service I has a first, second or third year resident, and a fifth year resident assigned to the service. Over half of this general surgery service is devoted to surgical oncology: particularly liver, gastrointestinal, spleen, pancreas, breast tumors, and other soft tissue tumors. The techniques of tumor resection, lumpectomy, sentinel lymph node biopsy, mastectomy, liver resection, and intraoperative ultrasound, gastrectomy, pancreatic resection, and splenectomy are learned on this service. The other half of this service is devoted to every day general surgery procedures.

General Surgery Service II is covered either by a second or third year resident. This service covers the renal transplant service. It also covers pediatric surgery. On this service, in particular, the residents learn the care of immunosuppressed transplant patients, the technique of angio access, vascular anastomoses, and pediatric surgery.

General Surgery Service III is covered by a first year, second or third year, and fourth year resident. Besides providing a wide variety of general surgery, including bariatric and pancreatic surgery, this service also cares for patients undergoing basic and advanced minimally invasive surgery.

General Surgery Service IV is manned by a first year resident, a second or third year resident, and a fifth year resident. This service also includes the resident Ward Service in which the Chief Resident functions as an attending surgeon for his/her own patients. Ward patients are seen in an outpatient clinic, assessed, scheduled for operation and operated upon by the Chief Resident with close cooperation and availability of the attending staff. Service IV also includes private general surgery patients. The service provides a strong experience in endocrine surgery, laparoscopic surgery, gastrointestinal surgery, oncologic surgery, and hernia repair. By necessity, this service requires close coordination with diagnostic and interventional radiology, pathology, and the gastrointestinal service, thus, teaches system-based practice. The service includes a weekly pathology review with the Chief Resident in pathology.

Vascular Service V is covered by a first year, second or third year, and a fifth year resident. This is a busy vascular service with complex patients. Common medical problems in these vascular patients include diabetes mellitus, cardiac disease, pulmonary disease and neurologic problems, including stroke. The residents learn and provide for the care of these patients and perform vascular surgery, including carotid, aortic, peripheral vascular, endovascular, and angio access surgery. The indications for and the technique of amputation are also learned on this service.

Night Float Service VI is primarily a cross-covering consultation and a trauma service. This service is covered by a senior and junior resident and three first-year residents. The residents will learn about the acute and chronic care of a variety of surgical specialties, including general surgery, vascular surgery, plastic surgery, urology, pediatric surgery, trauma surgery, and transplant surgery. You will learn how to evaluate patients in the emergency room, how to assess consults from within the hospital, and how to effectively provide cross-cover patient care. By necessity, this service emphasizes communication and systems-based practice.

General Surgery Service VII is primarily a colon and rectal service. A Chief Resident, a junior resident, and a first year resident cover this service. This is a busy service in which patients with colon rectal tumors, inflammatory bowel, and anorectal problems are cared for. This service provides experience in colonoscopy, endorectal ultrasound, gastrointestinal motility studies, colon and rectal resection, pull-through procedures, and anorectal surgery.

Trauma/Critical Care Service VIII is covered by a first year and a fourth year resident. At times, a third year resident also rotates on this service. Two emergency department residents at the second year level rotate on this service. This service is responsible for the comprehensive management of trauma patients. The service coordinates the care of patients with head and neck, chest, abdomen, and extremity injury. By its very nature, this service teaches systems-based practice.

This service also functions as a consultative critical care service and treats patients with severe soft tissue and pulmonary infections, respiratory failure, hemodynamic instability, renal failure, and major bleeding. Critical care patients in the general surgical intensive care unit are covered by a second or third-year general surgical resident under the direct supervision of a critical care attending who takes call in the hospital with the residents.

Thoracic Surgery Service is covered by a fourth year resident and a cardiac surgery resident. On this service, the fourth year resident is exposed to and performs thoracoscopy, lung resection, esophageal resection, upper endoscopy, and bronchoscopy. Esophageal manometry and gastrointestinal physiology are additional components of this service. Also, there is exposure to the advanced laparoscopic technique of Nissen fundoplication.

Cardiac Service is covered by a third year general surgery resident, who rotates with two cardiac surgery residents. A third year resident from general surgery covers one of several cardiac surgery operating rooms acting primarily as first assistant on open heart procedures. The technique of opening and closing the chest, harvesting of veins, and vascular anastomoses are learned. Pre- and postoperative care of cardiac patients in the intensive care unit is an important part of the educational experience.

Pediatric Surgery rotation consists of a one or two-month rotation at Children's Hospital of Pittsburgh. This provides all of the required experience in pediatric surgery. It involves not only pre- and postoperative care, but also outpatient care, as well as the management of common and complex pediatric surgical patients. The operative experience includes repair of pediatric hernias, pyloromyotomy, and the more common pediatric surgical cases.

Plastic Surgery During the first year of residency, a one-month rotation is spent on plastic surgery. The unique aspects of this rotation include the management of patients with myocutaneous flaps and breast reconstruction and the management of wounds and minor burns. Learning the aspects of wound healing, as well as suture techniques, are important components of this rotation.

Neurosurgery Service First year residents also spend one month on the neurosurgery service caring for neurosurgical patients preoperatively and postoperatively and managing care in the intensive care unit under the direct supervision of a pulmonary/critical care attending.

Emergency Room First year residents spend one month in the emergency room seeing emergency medical and surgical patients in the outpatient and preoperative setting.

Burn Surgery rotation consists of a one-month rotation at West Penn Hospital during the second year. This rotation provides all of the required experience in burns, including preoperative management, operative management (debridement, escharotomies, fasciotomies, and skin grafting), and postoperative management.

See Goals And Objectives For Each Year Of General Surgical Residency

This information is reposted with thanks to Allegheny General Hospital.