Transition to Discipline (PGY1, 3 months)
The first two weeks of PGY 1 are a surgical foundations bootcamp whereby residents are given a mix of didactic lectures and skills labs to facilitate a smooth transition to residency. PGY 1 residents are not assigned overnight call for the first two weeks of their residency.
After bootcamp, residents continue to have weekly Surgical Foundations protected academic time every Wednesday afternoon. The Surgical Foundations program (PGY 1 and 2 years) includes residents from general surgery, orthopedic surgery, urology and OB/GYN. It consists of a small group of residents, making for a close working relationship.
For the first 3 months of PGY1, we have all our new residents assigned to our various General Surgery CTU Teams. During this time, residents also complete their ATLS training. General surgery rotations for all years are divided amongst 5 clinical teaching units; CTU 1: Colorectal, CTU 2: Hepatobiliary, CTU 3: Oncology and Pediatric Surgery, CTU 4: Acute Care Surgery, CTU 6: Foregut and Bariatric Surgery.
Surgical Foundations (PGY 1 to PGY 2-3, 18-24 months)
Over PGY 1 and 2, residents will have the following blocks in no particular order; two blocks of vascular surgery, two blocks of ICU, two blocks of endoscopy, two blocks of thoracics, one block of ER, one block of plastic surgery and a split bock between anesthesia and radiology. The remaining blocks are General Surgery blocks, with two blocks completed at the Oshawa Lakeridge health site.
PGY 2 residents complete their Surgical Foundations exam in the fall. They are given one week of additional educational leave to facilitate studying and are exempt from call the 10 days before their exam.
About halfway through PGY 2, residents are transitioned into the senior resident role while on call as they are integrated into the night float system. Because of the small-medium program size, residents enjoy a significant amount of patient responsibility, care experience, and operative experience very early in their residency, tailored to the strengths of each residents.
Core of Discipline & Transition to Practice (PGY 3-5, Remainder of Residency)
During the PGY 3 year, residents will spend time in gastroenterology (one block), as well as general surgery (12 blocks, Kingston). Most residents also enjoy a community surgical experience in Napanee, which is 40min outside of Kingston, in either PGY 3 or PGY 4.
The PGY 4 year includes three or four elective blocks depending on the individual resident’s circumstances and interests, seven general surgery blocks in Kingston, and a one block trauma rotation at St. Michael’s hospital in Toronto.
The PGY 5 year is split between the CTU services on general surgery, once again tailored to each specific resident to allow for EPA completion. During the PGY 5 years, residents also participate in senior clinics and senior ORs where they are expected to run the clinic and ORs independently with minimal staff intervention, to simulate a day in their independent practice.
On Call Duties
Junior Call: This is in-house call and is typically covered by PGY 1&2s. Junior residents receive pages from the floor and carry the General Surgery trauma pager. There are no more than one in four nights of call scheduled, with post-call day relief of duties in accordance with the Professional Association of Residents of Ontario (PARO).
Senior Call: This is home call, covered by late PGY2s and other senior residents. There is a night float system whereby the residents covering ACS are paired for each both, and they each complete 2 weeks of daytime coverage and 2 weeks of night float (Sunday-Thursday). Residents covering night float do not stay the following day to participate in day-time coverage. This system allows for fewer post-call days interrupting clinical activities for senior residents. Over the weekend, call is covered by other senior residents who are not on night float, but with a significantly decreased call burden.
Senior residents accept consults, review consults with the junior resident and liase with the staff on-call. Though they do not carry the trauma pager, senior residents generally attend any traumas unless there is a simultaneous OR running. Some nights on senior call, residents are also assigned Trauma Team Captain call, in which case they are responsible for running traumas and coordinating further care.