Educational Curriculum: Didactics and Conferences

Introduction

Every Thursday begins with educational time for all residents rotating at Milstein Hospital. This educational curriculum includes the weekly resident teaching conference in addition to a rotating schedule of meetings such as Grand Rounds, Chairman's Case Conference, and Morbidity & Mortality. Columbia residents take an active role in their own education, with weekly readings and several assigned presentations throughout the year. Please read about each of the conferences in the sections below.

Thomas C. King (TCK) Conference 

The TCK conference is the primary resident teaching conference and covers material on both the American Board of Surgery In-Training Exam (ABSITE) and the General Surgery Boards based on the American College of Surgeons weekly curriculum. For much of the year, residents are divided into separate "junior" (intern and PGY2) and "senior" (PGY3 to PGY5) sessions, however some topics are presented in a combined format. A true "resident teaching" conference, all residents take turns preparing presentations on topics throughout the year. These presentations are reviewed and each session moderated by a faculty member specializing in the area being discussed. Junior sessions focus on the basic science and pathologic basis for disease processes while senior sessions emphasize clinical decision-making and operative planning and execution around each topic. Later in the academic year, senior sessions begin to focus on preparation for general surgery board exams. In addition we host a multi-institutional mock oral examination to help senior residents prepare for the American Board of Surgery Certifying Examination.

Department of Surgery Chairman's Conference 

Chairman's conferences are held every week where senior residents and fellows give in depth presentations of interesting or complicated cases. Faculty members throughout the entire department are present and cases are discussed in a multidisciplinary fashion. The goal of each presentation is to perform a root cause analysis of complications and discuss strategies for improvement in patient care. 

Department of Surgery Grand Rounds 

Grand Rounds are held once per month and involve guest lecturers invited from around the world to speak on a topic within their area of surgical expertise. Past speakers have included major contemporary figures in surgical history, department heads, and significant contributors to the advancement of surgical education and science. 

Morbidity & Mortality Conference 

M&M is held 2-3 times each month and is an active forum for review of complications. The primary operative residents present selected cases with a focus on analyzing the cause of each complication and discussing techniques to prevent future occurrences. Presentations include a review of relevant literature and current practices both within the department and throughout the country. Time is allotted for questions and collegial exchange between faculty and residents.

Evidence-based Algorithm Review Conference 

The Evidence-based Algorithm Review (EBAR) conference occurs 9 times per year. At this conference, PGY3 general and cardiothoracic surgery residents, under the direction of a faculty member, present a systematic review of the literature and the accepted practices for a given surgical pathology or condition. A forty-five minute presentation is followed by a moderated discussion between faculty and housestaff. At the conclusion of these conferences, an algorithm for the Department's Standard of Care for the given pathology is delineated. Topics have included the management of acute appendicitis during pregnancy, selection of mesh for ventral hernia repair, and the approach to End of Life care in surgical patients. At times, these sessions have served to stimulate new clinical research activities, some of which are ongoing.

Lunch & Learn 

Lunch & Learn is a daily informal conference at Milstein Hospital. The surgery department provides food and a rotating weekly schedule of didactics takes place during the lunch hour. This includes SESAP review, Vascular Surgery, Transplant Surgery, HPB Surgery, ACS Surgery, and Journal Club on a Monday to Friday schedule. Attendance is not mandatory, and residents who are able to attend find a relaxed and collegial learning atmosphere.

Specialty Service Conferences

Many of the sub-specialty services have their own academic conferences where specific patients and relevant topics are discussed. Often these conferences are multi-disciplinary and are attended by physicians from other fields. An example of this is the weekly Pancreas Conference for the Hepatopancreaticobiliary service. At this meeting, surgeons, gastroenterologists, radiologists, and oncologists discuss the work-up and management of all patients presenting to the center with a pancreatic mass. Residents are encouraged to attend and participate in these meetings. Other specialties with academic conferences include Vascular Surgery, Surgical Oncology, Endocrine Surgery, Renal Transplantation, Liver Transplantation, Pediatric Surgery, Colorectal Surgery and Critical Care. 

Allen Hospital 

In addition to Thursday morning conferences at Milstein, Residents rotating at the Allen convene on Wednesday mornings to discuss service complications as well as interesting cases. Presentations are generally given by junior residents and rotating medical students. 

Overlook Hospital

The residents rotating at Overlook Hospital are not able to participate in conferences at Milstein. However, they have multiple education conferences including Tuesday and Thursday morning didactics with the Chair of Surgery, Dr. Paul Starker. Wednesday morning conferences cycle between General Surgery and Vascular M&M, and Tumor Board - a multidisciplinary conference that reviews oncology patients at the hospital.