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Residency
Program
- Application
- Residency Program Structure
- Working Schedule
- Goals and Duties
- Recent
Graduates
- Salaries and benefits
- Research
- Campus
info
Contact:
Glenda
L. Casanova
Secretary
Residency Program Coordinator
787-765-5183
787-758-2525 x 1903
email: gcasanova@rcm.upr.edu
University District Hospital
San Juan Hospital
University of Puerto Rico Hospital
Goals
1. Expose residents to a wide variety
of general surgical conditions:
· Clinical presentation
· Work up
- Cost effectiveness
· Clinical judgment
2. Active exposure to surgical procedures
towards the development of technical expertise.
3. Bedside manners
4. Administration of the service
Duties
PGY-1:
1. Perform assigned duties by SENIOR
RESIDENT.
2. History and physical exams to all
admitted patients.
3. Evaluate patients at ER – present
them to higher level resident.
4. Evaluate patients at outpatient
clinics – discuss with senior residents or attending.
5. Perform minor surgical procedures
under direct supervision: central lines placement, chest tube insertion,
Foley catheter insertion, NG tube insertion, suture lacerations, closure
of wounds.
6. Assist in operating room.
7. Surgeon with attending or senior
resident.
8. Knowledgeable in CV monitoring;
ventilator support and ABG’s interpretation, nutritional assessment
and support.
PGY-2:
1. Same duties as PGY-1.
2. Increased duties in direct patient
care at emergency room, ward, OPD
3. Teach medical students.
PGY-3:
1. Supervise lower level residents
2. Active involvement in direct patient
care at Emergency Room, ward, ICU OPD.
3. Assist in operating room.
4. Surgeon with attending
PGY-4:
1. Supervise lower level residents.
2. Help senior resident in running
the service.
3. Surgeon in more complex casers
with attending staff.
4. Acting senior in night duties in
house.
5. Prepare and present seminars, book
reviews, etc.
6. If senior is absent, assumes responsibilities
of PGY-5
PGY-5:
1. Running the service.
2. Perform major procedures as surgeon
with attending staff.
3. Assist in operating room to lower
level residents.
4. Supervise lower level residents.
5. Run the outpatient clinic.
6. Prepare and present cases/topics
at G-I medico-surgical conference.
7. Prepare and present M & M,
seminars, book reviews, etc.
8. In charge ICU patients.
Goals
1. Expose residents to the multidisciplinary
management of the Cancer patients
2. Multidisciplinary tumor planning
conference
3. Expose residents to a wide variety
of oncology procedures
4. Acquire knowledge in chemotherapy
and radiotherapy
5. Expose our residents to most common
gynecological conditions, evaluation and surgical management
6. Exposure to national research protocols
A.
National Research Protocols
· San Juan Clinical Community
Oncology Program
1.
NASBP
2.
ECOA
3.
MD Anderson
· Florida Melanoma Clinical
Trials
· American College of Surgeons
Oncology Group
· Puerto Rico Cancer Center
with Moffitt Partnership P-30
· Puerto Rico Cancer Center
with MD Anderson Partnership – U-54
Goals
1. Expose residents to the acute and
subacute management of the trauma patients
2. Develop expertise in initial evaluation
and stabilization at the Emergency Room level (the ABC of trauma management)
3. Develop expertise in obtaining
vascular access for IV Rx and volume management
4. Initial work-up at Emergency Room
level
5. Develop clinical judgment in these
acutely and critically ill patients
6. Develop expertise in life saving
surgical procedures:
· Chest tube insertion
· Endotracheal intubation
· Thoracentesis
· Thoracotomy
· Pericardiocentesis
· Peritoneal lavage
· CPR, etc.
7. Develop expertise in the surgical
management (intra operative)
8. Develop expertise in the critical
care of these patients:
· Invasive hemodinamic
monitoring
· Fluids
· Ventilatory support
· Sepsis
· Nutritional support
9. Develop sensitivity toward the
emotional stress involved in trauma cases
10. Psychological support (patient and relatives)
Duties
PGY-1:
1. Admission work-up
2. Working Rounds
3. Patient Care
4. Initial Patient Evaluation
5. Initial Patient Management
6. Resuscitation of victims
7. Recognition of spinal cord, had
trauma and peripheral nerves
PGY-2:
1. Admission work up
2. Working Rounds
3. Patient Care
4. Initial patient evaluations
5. Initial patient management
6. Invasive monitoring
7. Bedside Procedures
PGY-3:
1. Invasive monitoring
2. Serves as teacher of lower level residents
3. Bedside procedures
4. Assistant to Senior
PGY-4
1. Management of entire service
2. Responsible for all patients management
3. Assigns duties as needed for proper care of patients
4. Presents and consults patient and management with attending staff
5. Group tender of trauma team, day and night as case may be
6. Scheduling of patients
7. Teacher of lower lever residents
8. Invasive procedures
9. Operating room
10. Surgeon or first assistant.
1. Expose residents to most frequent
CV conditions:
· Clinical presentation
· Diagnostic procedures
· Medical management
2. Exposure with active involvement
to complex intensive care critical surgical care
· Cardiac and pulmonary
physiology
3. Exposure to thoracic and vascular
surgery with active involvement
Due to the complexity of these cases, residents mostly act as first
assistants. A gradual increase in technical involvement occurs with
increases in exposure and level of training.
Goals
1. Expose our residents to as much
pediatric surgical conditions as possible with emphasis on the most
frequent ones
· Clinical presentation
· Work up
- Cost effectiveness
· Clinical judgment
2. Expose residents to the surgical
management of these conditions
· As primary surgeons
· As assistants to Pediatric
Faculty in complex procedures
3. Critical care exposure in the pediatric
patients at all levels:
· NICU
· PICU
Duties
PGY-1:
1. History and Physical Examination,
daily progress, chart keeping and documentation
2. Coordinate work-up and studies
of patients
3. Daily rounds and clinics (weekly).
Pre admission clinic, History and Physical Examination
4. Examine patients in rounds and
clinic
5. Assistant in Operating Room (elective
and emergency)
6. Participate in attending teaching
round
7. Participate in Tumor Board (weekly)
8. May perform simple procedures under
supervision of senior resident or attending at ward, special care
units and Operating Room
PGY-2:
1. Supervision and teaching of PGY-1
at ward and clinic
2. Distribution of work and residents
3. Schedule operating room cases
4. Perform surgery with attending
supervision and assist attending at Operating Room (elective and emergency)
5. Present cases at Tumor Board
6. Present mortality and morbidity
at surgical teaching activities
7. Responsible for Operating Room,
consult, procedure statistics at the Department
8. Present and discuss cases with
the different attendings on elective or emergency basis
9. Discuss a topic at the neonatal
surgical conference (monthly)
10. Participate in the teaching and supervision of medical
students (MS III and MS IV)
Goals
1. Expose our residents to the immunocompromised
patients
· General management
· Critical care (all aspects)
· Immunotherapy
2. Expose residents to vascular surgery
3. Expose residents to transplant
surgery patients
· Recipient selection
and evaluation
· Donor selection and
evaluation: Cadaver and Live-Related
· Management of end stage
renal disease including diet, medications, complications, hemodialysis
· Vascular access for
Dialysis
· Nephrectomy and splenectomy
· Histocompatibility testing
· Donor nephrectomy and
Kidney transplantation
· Prophilactic immunocuppression
· Treatment of rejection
· Short and long-term
follow-up of renal transplant patient
· Results and complications
of renal transplantation
· Organ harvesting and
perfusion-preservation in human and animals
4. At the end of two-month rotation,
the resident should have developed the following general objectives
and skills:
· Know the indications
of renal transplantation and the general guidelines for selection
and evaluation of kidney transplant recipients.
· Know the general evaluation
and selection of both cadaver and living related kidney donors.
· Know the general management
of end-stage renal disease.
· Perform vascular access
operations under supervision
· Perform bilateral nephrectomy
and splenectomy under supervision.
· Perform initial dissection
for kidney transplantation under supervision.
· Know the general post-operative
management of kidney transplants recipients including post-operative
care, rejection, immunosuppression and complications.
Duties
PGY1 & PGY-2:
1. Daily renal rounds (morning)
2. Daily transplant rounds (afternoon
3. Transplant clinics
4. Prepare presentations to the Transplant
Planning Conference (weekly)
5. Donor and recipient evaluation
meetings
6. Research Conference
7. Biopsy Review
8. Journal Club (weekly)
9. All Vascular Access Operations
*
10. All operations on transplant patients *
11. All renal preservation perfusions *
12. Hemodialysis rounds
13. Acute dialysis treatment
14. Attendance during at least one histocompatibility testing
15. Preparation of donors and recipients for the various procedures
and operations.
16. Post-operative management of donors and recipients
17. Independent reading from the renal and transplant libraries
of the various renal and transplant staff physicians
* The resident will perform the various procedures and operations
commensurate with his/her experience and expertise.
Veterans Administration Hospital:
Goals
- Expose residents to a wide variety of general surgical conditions:
· Clinical presentation
· Work up
- Cost effectiveness
· Clinical judgment
- Active exposure to surgical procedures towards the development
of Technical expertise.
- Bedside manners
- Administration of the service
- Expose residents to the multidisciplinary management of the cancer
patients.
· Multidisciplinary tumor
planning conference.
- Expose residents to a wide variety of oncology procedures
- Acquire knowledge in chemotherapy and radiotherapy
- Exposure to national research protocols:
· San Juan Clinical Community
Oncology Program.
- Develop expertise in obtaining vascular access for IV Rx and volume
management
- Develop clinical judgment in these acutely and critically ill
patients
- Develop expertise in life saving surgical procedures:
· Chest tube insertion
· Endotracheal intubation
· Thoracentesis
· Thoracotomy
· Pericardiocentesis
· Peritoneal lavage
· CPR, etc
- Develop expertise in the clinical care of these patients:
· Invasive CV monitoring
· Fluids
· Ventilator support
· Sepsis
· Nutritional support, etc
- Expose residents to a wide variety of peripherovascular procedures
making emphasis in pre operative work up and clinical judgement
14.Developed experience in flexible endoscopies.
Vascular Surgery:
Goals
1. Knowledge of:
· Risk factors for develop
peripherovascular diseases
· Cardiac evaluation of
the peripherovascular patient
2. Evaluation and diagnosis of peripherovascular
conditions
3. Medical and surgical treatment
of common periperovascular conditions:
a.
Arterial origin
· Cerebrovascular disease
(carotid/vertebral)
· Aorto-iliac disease
· Femoro-distal disease
· Aneurysm (aortic/peripheral)
· Trauma
· Congenital malformation
b.
Venous origin
· Chronic venous insufficiency
· Thrombophlebitis
· Pulmonary embolism
· Congenital malformation
4. Lymphedema
5. Development of surgical skills
in vascular reconstruction
Duties
PGY1:
1. Admission, history and physical
exam
2. Daily ward rounds
3. Attendance to clinics
4. Assist in the operating room
5. Develop knowledge of what constitute
vascular evaluation
PGY5:
1. Manage the Vascular Surgery Service
2. Supervise the PGY1
3. Daily ward rounds
4. Attendance to clinics
5. Become familiar with the evaluation
and management of vascular patients
6. Become proficient with performance
of basic vascular reconstructive procedures
Surgical Intensive Care Unit
1. Expose residents to the acute and
subacute management of the surgical critical care patients
2. Develop expertise in Initial evaluation
of critically ill patients at the Intensive Care Unit
3. Develop expertise in obtaining vascular
access for IV Rx and volume management
4. Develop knowledge and proficiency
in the use of Swan-Ganz Catheter
5. Develop clinical judgment in these
acutely and critically ill patients
6. Develop expertise in life saving
surgical procedures:
· Chest tube insertion
· Endotracheal intubation
· Thoracentesis
· Thoracotomy
· Pericardiocentesis
· Peritoneal lavage
· CPR, etc
7. Develop expertise in the evaluation,
recognition and treatment of surgical problems in critical care patients.
· Invasive hemodynamic monitoring
· Fluids
· Ventilatory support and
modalities
· Sepsis
· Immunomodulation
· Cardiovascular pharmacological
support
· Management of renal failure
· Hemodyalisis dynamics
· Hematopoietic problems
· Gastrointestinal failure
· Liver insufficiency and
failure
8. Develop sensitivity toward the emotional
stress involved in these cases.
· Psychological support
(patient and relatives)
· Emotional support physical
therapy and rehabilitation
Plastic and Reconstructive Surgery
1. Attend the clinics and participate
in evaluating patients
2. Attend the operating Room and assist
in the procedures
3. Help in the process of completing
the patient’s admission
4. Perform daily rounds on admitted
patients
5. Discuss cases with the Attending
and prepare for surgical treatment and care of the patients
6. Participates in the decision-making
process of selecting the proper surgical procedure for the cases
7. May perform part or all of the surgery
under supervision of the attending
Recent Graduates
2001
Karim A Benitez Marchand
Plastic and Reconstructive Surgery
University of Illinois, Chicago, IL
Alberto M Maldonado Molina
Private Practice, Puerto Rico
Felix R Roque Velazquez
Private Practice, Puerto Rico
Hiram M Soler Bernardini
Private Practice, Puerto Rico
Jorge A Toro Burguete
Private Practice, Puerto Rico
2000
Diego R Solis Lopez
Gainesville Hospital Transplant Program
University of Florida
Ian R Soto Lopez
Private Practice, Puerto Rico
1999
Francisco J Blanes Mayans
Private Practice, Puerto Rico
Ivonne M Daly Guzman
Transplant Surgery
University Health Center of Pittsburgh, Pennsylvania
Hector L Irizarry Rivera
Plastic and Reconstructive Surgery,
University of Michigan, Ann Arbor, MI
Assistant Professor, San Juan Veterans Affairs Medical Center
Joel Toro Pagan
Plastic and Reconstructive Surgery
University of Indiana, Indianapolis, IN
1998
Jose L Colon Colon
Private Practice, Puerto Rico
Armando de la Cabada Miranda
Private Practice, Florida
Maria T Ocasio Carle
Private Practice, Puerto Rico
Jose D Pagan Gonzalez
Assistant Professor, Department of Surgery, University of Puerto
Rico
Private Practice, Puerto Rico
Reinaldo Reyes Delfaus
Assistant Professor, San Juan Veterans Affairs Medical Center
Private Practice, Puerto Rico
1997
Miguel A Alvelo Rivera
Cardiothoracic Surgery
University of Pittsburgh
Sandra E Marrero Ortiz
Private Practice, Puerto Rico
William Mendez Latalladi
Assistant Professor and Student Program Coordinator
Department of Surgery, University of Puerto Rico
Private Practice, Puerto Rico
Edwin A Torres Rivera
Private Practice, Puerto Rico
From our graduates, 55% started private practice,
30% continues fellowships
and 15% join our department as an academic position.
BACK
Salaries and benefits
Annual stipend of $30,000.00
30 days of vacation
18 days of sick leave
8 weeks of maternity
2 weeks of paternity
Medical insurance
Life insurance
Workmen Compensation Fund
In house meals reimbursement
On call rooms
Parking
One day free per week
Maximum of 80 working hours per week
Moonlighting is allowed but the resident need to follow the Graduate
Medical Education policy
Research
For the past several years, residents have been
chosen to do one year of basic research after their first or second year
of training. Areas of research are in oncology, trauma and transplant
surgery. The projects are to be submitted for publication or presentation
at a professional conferences or symposiums.
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