Ascension St. John Hospital Surgery Residency
Elango Edhayan, M.D.
Chief and Program Director, Department of Surgery
Ascension St. John Hospital offers a five-year residency training program in General Surgery. Ascension St. John Hospital is a 776-bed teaching facility that includes 66 intensive care beds. The surgical program is oriented to meet the requirements of Accreditation Council for Graduate Medical Education, the American College of Surgeons and the American Board of Surgery. The Department of Surgery has been at the forefront of all technical changes in the past few decades. The first laparoscopic cholecystectomy is Michigan was performed in our operating rooms. We were also amongst the first hospitals in the nation to do Aortic stent grafts. We now have a Da Vinci Robotic system for robotic surgery. It is the only hospital in Michigan with an advanced laparoscopy fellowship. This is a hands-on program with supervised operative experience from very early on. Our chief residents were in the 90th percentile in all categories of operative experience required by the American College of Surgeons. In addition to being a tertiary referral center for the Ascension St. John Health System, Ascension St. John Hospital is also a regional trauma center and a regional surgical oncology center. The hospital and the teaching staff are deeply committed to your education.
The program concentrates its educational thrust at the following required prime components:
- head and neck
- alimentary tract
- abdomen and its contents
- breast, skin and soft tissue
- peripheral vascular system
- trauma to include musculoskeletal system and head injuries
- endocrine system
- surgical oncology
- complete care of the critically ill
In addition to the prime components, further essential knowledge in the basic areas of education is required, including:
- wound healing
- hemostasis and blood disorders
- oncology and transplantation
- circulatory physiology
- surgical bacteriology
- muscle and bone mechanics and physiology
- respiratory physiology
- genito-urinary physiology
- gastrointestinal physiology
- surgical endocrinology
- surgical nutrition
- fluid and electrolyte balance
- metabolic response to injury
- surgical anatomy
- surgical pathology
The program is organized with the objective of a bedside and direct clinical approach in teaching residents to give them a complete training experience in the care of surgical problems. As the skills and knowledge of residents grow, they are given the opportunity to perform surgery commensurate with their skill, under supervision. As residents progress through the five years of training, each year offers more responsibility. In addition to acquiring professional knowledge, residents are made aware of the high moral and ethical standards required of the surgeon. Upon completion of this training, they will be fully trained, competent surgeons.
The surgical training program is under the direction of the Program Director who, in cooperation with the assistant program directors, outlines the entire prospectus for the five years of training, arranges the services and their composition, arranges the clinical conference topics and delegates speakers and attending surgeons to the task of carrying out these assignments.
The Program Director takes an active part in all parameters of the program, evaluating the attending teaching staff as to their teaching effectiveness and intermittently evaluating the progress of each resident.
Evaluation of the resident staff includes:
- American Board of Surgery In-Training Examination
- Monthly surgical text review examination
- Basic science written examination
- Mock oral board examination for senior residents
All surgical staff members are certified by the American Board of Surgery. All are highly qualified and keenly interested in the teaching program. The members of the surgical staff have specific teaching assignments and responsibilities in furthering the quality of the program. Many members hold faculty rank at Wayne State University School of Medicine. There are highly qualified and excellent teaching staff in the subspecialty services of orthopedics, neurosurgery, thoracic surgery, plastic surgery, urology, pediatric surgery, hand surgery, and transplant surgery.
The Chief of Surgery is responsible for the quality of the residency training program including the performance of the surgical staff and the overall supervision of the residency training program.
The ambulatory care of the surgical patient takes place in the Hospital Outpatient Clinic and once a week rotations through the attending physicians offices. A valuable experience is obtained from this assignment. The resident will access patient pre and post operatively as well as seeing long term follow-up cases.
Participation in research allows for a better understanding of surgical literature and advancement of medical knowledge. All residents are required to perform at least one research project, but many exceed this with multiple regional and national presentations and publications. Ascension St. John Hospital participates in many national multicenter protocols. In addition to this, numerous clinical projects initiated at Ascension St. John Hospital are currently ongoing. The laboratory at Wayne State University is also available for bench research projects for both the residents and the surgical staff of Ascension St. John Hospital.
The Emergency Department
The Emergency Department of Ascension St. John Hospital is one of the busiest in the metropolitan Detroit area. Each month, approximately 7,500 patients receive medical care in the Emergency Center. Surgical emergencies offer a comprehensive and extensive experience to the resident. Practically any and all forms of critically injured patients are encountered in the Emergency Center. Ascension St. John Hospital is verified trauma center by the American College of Surgeons. The number of trauma cases is considerable. A well-developed trauma staff of surgical residents function 24-hours a day. The number of non-traumatic surgical emergencies is also considerable and diverse.
All conferences are clinically oriented with detailed discussion of problem cases, particularly those in controversial areas of surgical management. Active participation by all residents in these cases provides a very important facet in the training program. Most of these conferences include a PowerPoint presentation. A number of guest lectures and national known speakers occur on a regular basis.
An active Journal Club including staff participants meets monthly. The topics cover cutting edge surgical technology, current controversial topics in surgery, as well as revising basic surgical principles stressing evidenced based medicine. The Journal Club allows for an interactive forum with lively discussions and educates residents on critical appraisal of the literature.