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Department of Surgery

Residency/Fellowship Programs

 

Policies


 

 

Resident Duty Hours

 

This policy and procedure describes resident duty hours for the Department of Surgery at Temple University Hospital.

 

It is the philosophy of the Department of Surgery at Temple University Hospital that graduate education in surgery requires a commitment to continuity of patient care. For this reason, it is expected that residents will participate in the preoperative, operative and postoperative care of their patients. This continuity of care does take precedence over any on-call schedule.

 

However, it is also a priority in the Department of Surgery at Temple University Hospital to train residents in an environment that is optimal for resident education and patient care.

 

Duty hours will be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities. In-house call will occur no more frequently than every third night, averaged over a four-week period. Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours. Residents may remain on duty for up to 6 additional hours to participate in didactic activities, maintain continuity of medical and surgical care, transfer care of patients or conduct outpatient continuity clinics. No new patients may be accepted after 24 hours of continuous duty. Residents will be provided with 1 day in 7 free from all educational and clinical responsibilities averaged over a four- week period. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.

 

All residents are required to keep track of their duty hours on GME toolkit. If by the 5th of the following month duty hours are not complete, residents will be sent home. Duty hours will be checked every two weeks by the residency staff.

 

In accordance with the institutional policy, residents are given meals when on call as well as an on call room.

 

In the event that any resident experiences fatigue that is interfering with his/her ability to safely perform his/her duties, they are strongly encouraged and obligated to report this to his/her senior resident or attending surgeon on service. Appropriate coverage will be arranged as well as any other necessary support. Attending surgeons and surgical residents are instructed to closely observe residents for any signs of undue stress and/or fatigue. This should be immediately reported to the supervising attending and/or Program Director. The resident will be relieved of his/her duties until the effects of fatigue are no longer present. They will also be provided with any other necessary support.

 

Residents are given three weeks vacation a year. In their chief year, residents are given additional time to attend a surgical conference.

 

The institutional policy addresses Sick Time, Funeral Leave, Maternity and Paternity Leave.

 

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Residency Policies and Procedures

 

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Resident Evaluation of Surgical Faculty and Surgical Residency Program

 

This policy and procedure delineates the Department of Surgery policy for the evaluation of the surgical faculty and the surgical residency program.

Residents will fill out an anonymous evaluation of each attending on their respective service at the end of the rotation. This will be performed on-line. Evaluations will be compiled by the residency coordinator and submitted to the Chairman and Program Director. These evaluations will be discussed with the departmental faculty at least semiannually.

 

All residents are also expected to anonymously evaluate the residency program. This will be done on-line as well. Rotations, conferences, and hospital services, will be evaluated. This provides a confidential means of evaluation. These evaluations are reviewed and used to improve the residency program.

 

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Resident Supervision

 

This policy and procedure delineates the mechanisms for acceptable supervision of surgical residents at Temple University Hospital.

 

It is the policy of the Department of Surgery at Temple University Hospital that all surgical residents, regardless of level of training, be supervised by a faculty member in all clinical activities.

 

It is the philosophy of the Department of Surgery at Temple University Hospital, that all patients on the surgical services, either inpatient or outpatient, be assigned an attending surgeon who is responsible for that patient. The attending surgeon has both an ethical and legal responsibility for the overall care of the patient and for the supervision of the residents involved in the care of that patient.

 

Proper supervision takes into account the care of the patient as well as the training of the resident to participate in independent decision making. The degree of supervision will vary with the clinical circumstances and the training level of the resident. These judgments will be based on the attending surgeon's direct observation and knowledge of each resident's skill and ability.

 

On those instances where the attending surgeon is not in-house, house staff are instructed on how to contact attending surgeons. All surgeons are available by pager. The page operator has available an up-to-date call schedule with attending beeper numbers and home phone numbers.


If a resident at any level finds that there is not a rapid reliable system for communicating with a supervising attending, this should be immediately reported to the Program Director or Chairperson.

 

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Guidelines for Non-Resident Surgical Service (NRSS)

 

  1. The core values of the Temple Department of Surgery include quality, respect, safety, teamwork, integrity and trust.
  2. Monday through Friday 7am until 7pm, residents and medical students will not be routinely involved in NRSS patient care in the operating room (including SPU and prep/hold), on the floors (e.g. 9W, 5E), in the ER, or in the clinic.  An exception may be made for life threatening emergencies. 
  3. SICU patients on the NRSS will be cared for by the SICU team (attendings, residents, nurses) as they are now.  To the extent possible, communication regarding patient care in the SICU should be between NRSS attendings and SICU attendings or nurses.
  4. Communication is important for good patient care.  Appropriate sign out between the covering resident team and the NRSS team should occur each morning and evening as necessary.  Urgent patient care issues should be communicated directly to the NRSS attending.
  5. Urgent or emergent operations at night or on the weekend will be covered by the surgical residents.  The covering resident(s) will not be required to round on these patients postoperatively; however with the permission of the NRSS attending they may follow routinely the patient during the postoperative period for educational purposes.
  6. Residents will cover the NRSS attendings when they are on call. Residents will not round on the NRSS patients on the weekend. Occasionally, they may be asked to check and report on a floor patient.
  7. Residents may be asked to perform procedures on NRSS patients (e.g. nasogastric tube insertion, CVP insertion) if necessary.
  8. NRSS attendings may offer elective rotations for surgical residents and fourth year medical students.  NRSS attendings are expected to participate in departmental conferences and meetings.


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