Ucla Department of Surgery

UCLA RESIDENCY PROGRAM IN GENERAL SURGERY

POLICY AND PROCEDURES

DATE: June 3, 1998 UPDATED: April 12, 2006

SUBJECT: PARTICIPATION IN THE EDUCATIONAL PROGRAM

PURPOSE: To establish and communicate expectations for both faculty and trainees regarding participation in the educational program.

POLICY: Ongoing participation in the educational program is the mutual responsibility of the faculty and the trainees. The following expectations are outlined to enhance the educational process.

I.  Attendance of Teaching Conferences:

Wednesday conferences are an integral component of the educational program. These conferences are compulsory for all residents. Attendance will be documented by personnel signature recorded on the sign-in sheet. The absence of a signature will be regarded as an unexcused absence. Failure to comply with the minimal attendance standards set forth below or the failure to demonstrate an effort to attend conferences may result in probationary action for trainees.

Excused absences will be allowed in the following circumstances:

A.  Notification of the Surgery Education Office (310 825-6557) prior to or within 48 hours of the conference date.

B.  Scheduled vacation time.

C.  Approved absence from the program such as meeting travel, interviews, and leaves.

D.  Post call residents.

II. Ambulatory Patient Care:

Exposure to the continuity established in the preoperative evaluation and postoperative

visit(s) is essential to the training of surgical housestaff. For this reason, the following

expectations have been established:

A.  UCLA Center for Health Sciences: All first and second-year trainees will attend the outpatient clinic for their service a minimum of one-half day per week, unless the trainees’ immediate attention is required for other patient care. The following rotations are exempt from this objective:

  1. Liver Transplantation ICU
  2. Cardiothoracic Surgery ICU

B.  West Los Angeles VA Medical Center and Sepulveda VA Medical Center: All trainees will attend the outpatient clinic for their service a minimum of one day per week, unless the trainees’ immediate attention is required for other patient care.

C.  Olive View-UCLA Medical Center: All trainees, with the exception of the resident physician on-call for General Surgery, will attend each outpatient clinic scheduled for their service unless the trainees’ immediate attention is required for other patient care.

D.  Kaiser Medical Center, Panorama City: All trainees will attend the outpatient clinic as directed by the site resident coordinator or their designee.

E.  Los Angeles County-USC Medical Center Burn Unit: All trainees will attend the outpatient clinic as directed by the site resident coordinator or their designee.

  1. Operating Room Experience
  1. All trainees, irregardless of institutional assignment, are expected to attend the operating room.
  2. Trainees are expected to accomplish the following in participating in operative cases:
  1. Prior to the operation, make themselves familiar with the patient’s history including diagnostic studies, and have an understanding of the indications for surgery.
  2. Personally examine the patient prior to operation
  3. Document their involvement with a preoperative note.
  4. Consult with the attending physician regarding the operative care to be delivered.
  5. Personally participate in the operation.
  6. Document a summary of the operation in the form of a brief, handwritten operative note.
  7. Personally participate in the immediate in-hospital postoperative care of the patient and document that participation in the form of a postoperative note in the medical record within the first 48 hours after operation.
  8. Participation in the outpatient postoperative care of the patient by personally seeing the patient in the outpatient setting and determining follow-up care.

Invasive Procedures

All trainees must perform, under appropriate supervision, the requisite number of invasive procedures to demonstrate competency. All first-year trainees will be observed during a probationary period until competency has been established by successful performance of the requisite number of procedures. During this probationary period, the following criteria must be met:

All procedures must be performed in the presence of a supervising resident physician or attending physician.

Each trainee is expected to learn the indications, technical maneuvers, and possible complications of each procedure.

Trainees will provide the patient with informed consent regarding the procedure, and document, either by signed consent form, or by handwritten note that consent was given.

Trainees will document performance of the procedure with a handwritten note in the medical record noting the procedure, indication(s), procedurist and their supervising resident or attending physician, anesthetic used, and any complications.

Trainees will maintain a log of procedures completed to document his/her activity.

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