The busy ACS service provides broad exposure to the diversity of clinical problems in general surgery. Strong support from mid-level practitioners on the service means interns are frequently sent to the operating room. They also get their first experience in the triage, work-up, and management of acute general surgical problems seeing consults at Rhode Island Hospital.

The Anesthesia rotation involves residents in perioperative patient management, especially as it relates to cardiovascular, respiratory, and metabolic changes that accompany surgery. Mastery of common procedures including endotracheal intubation, as well as arterial and central line placement, is emphasized.

The emergency medicine rotation focuses on acute care management and critical care, development of a comprehensive differential diagnosis, and coordination of healthcare with other services.

With a busy elective and emergency general surgery service, interns at The Miriam Hospital gain significant exposure to the full breadth of general surgery, seeing consults in the Emergency Department. As one of the most heavily operative rotation for interns, dedicated time in the OR for interns is a highlight of this rotation.

One of the most heavily operative rotations for interns, Pediatric Surgery provides the opportunity to learn the surgical management of ill children.  Further, Hasbro Children’s Hospital, a Pediatric Level 1 Trauma Center, relies on the Pediatric Surgery team to lead the work-up and management of pediatric trauma. Interns see all surgical consults in the Hasbro Emergency Department and participate in daily teaching rounds on the floors, PICU, and NICU.

The SICU intern manages critically ill trauma patients in the 8-bed Surgical ICU. The fundamentals of managing critically ill surgical patients are emphasized on daily teaching rounds. Residents gain experience in central and arterial line placement, endotracheal intubation, percutaneous tracheostomy, and bronchoscopy.

The TICU intern manages critically ill trauma patients in the 11-bed Trauma ICU. The fundamentals of managing shock and respiratory failure are emphasized on daily teaching rounds. Residents gain experience in central and arterial line placement, endotracheal intubation, percutaneous tracheostomy, and bronchoscopy.

The trauma intern manages multisystem trauma and burn patients on the floor and is involved in primary resuscitation in all level A and B trauma activations. The trauma intern is routinely assigned to primary and secondary burn reconstruction operations.

The surgical service at the VA provides a high volume of general, vascular, and thoracic surgery, as well as experience in head and neck surgery. The busy clinics allow residents to enjoy continuity with their patients. The minor procedure room is the ideal learning environment for interns to master fundamental surgical technique.

The vascular intern develops skills in work-up and management of peripheral vascular disease, as well as complex wound management. Teaching conferences emphasize vascular anatomy and perioperative management of patients with significant cardiac and respiratory co-morbidities. The service is also home to Rhode Island’s renal and pancreatic transplant program.

PGY-2s return to ACS as the General Surgery consult resident at Rhode Island Hospital. There is sufficient operating room experience between consults. They are responsible for overseeing the general surgery inpatient services overnight.

The PGY-2 Dermatology rotation includes significant time in Mohs surgery, the interdisciplinary melanoma clinic, general dermatology clinic, and the dermatopathology lab.

The rotation at Newport Hospital is heavily operative, including cases in complex abdominal surgery as well as oncologic surgery.

The PGY-2 Ophthalmology rotation provides the opportunity to improve the ocular exam, especially as it relates to trauma or complications of periorbital surgery. Accordingly, time is spent in the operating room with Oculoplastic Surgery as well as in the Emergency Department and inpatient floors seeing consults with the Ophthalmology residents.

The goal of the Oral/Maxillofacial Surgery rotation is broadening the residents' exposure to orthognathic surgeries and complex mandible reconstruction.

Returning to the Vascular Surgery services as a PGY2, plastic surgery residents serve as the dedicated Transplant resident. They perform a large number of dialysis access procedures and are involved in renal and pancreatic transplants.

Residents are primarily dedicated to craniofacial/pediatric plastic surgery, facial aesthetic and oculoplastic surgery, as well as oral and maxillofacial surgery.

Residents spend most of their time on surgery of the hand, upper extremity, and peripheral nerve. The PGY-4 or 5 is the dedicated VA resident and is responsible for clinics and cases at the VA.

While on the busy orthopedic trauma service, PGY3s learn the surgical management of complex long bone fractures, both in the Emergency Department and in the OR. Transitioning to the orthopedic hand service, the resident gains experience in the clinic and operating room with a high volume of elective hand, elbow, and shoulder procedures.

The PGY3 ENT rotation involves participation in the operating room for the full breadth of adult and pediatric head and neck surgery. The clinic experience affords sufficient exposure to nasopharyngoscopy and other minor procedures. Consults provide complementary experience for management of facial trauma, complex airway management, and head and neck infections.

Residents cover a broad range of reconstructive and aesthetic surgery, including reconstruction of the head & neck, breast, abdomen, trunk, and lower extremity. They utilize the diverse expertise of the team attendings and employ the full breadth of reconstructive options, including free tissue transfer.

One month of each year PGY4-6 is spent on away rotations to complement their experience in Rhode Island. These rotations are organized with the assistance of department personnel and may include a variety of domestic or international experiences, including mission trips like Operation Smile. Recent graduates have used this time to train at the following institutions:

• Chang Gung Memorial Hospital (Taipei, Taiwan)
• MD Anderson Cancer Center (Houston, Texas)
• Memorial Sloan Kettering Cancer Center (New York, New York)
• The Buncke Clinic (San Francisco, California)
• The Hospital for Sick Children (Toronto, Canada)
• Massachusetts General Hospital (Boston, Massachusetts)
• Asan Medical Center (Seoul, South Korea)
• Seoul National University Hospital (Seoul, South Korea)
• Hospital de la Santa Creu i Sant Pau (Barcelona, Spain)

Residents are primarily dedicated to craniofacial/pediatric plastic surgery, facial aesthetic and oculoplastic surgery, as well as oral and maxillofacial surgery.

Residents spend most of their time on surgery of the hand, upper extremity, and peripheral nerve. The PGY-4 or 5 is the dedicated VA resident and is responsible for clinics and cases at the VA.

Residents cover a broad range of reconstructive and aesthetic surgery, including reconstruction of the head & neck, breast, abdomen, trunk, and lower extremity. They utilize the diverse expertise of the team attendings and employ the full breadth of reconstructive options, including free tissue transfer.