Attendings

M. Parker Roberts III, MD	Marie C. Audett, MD	Joseph D. Mack, MD
Kathreen Portia Lee, MD

Expectations

The colorectal service provides care for a wide range of complex benign and malignant diseases by employing endoscopic, robotic, laparoscopic and open surgical techniques. We work closely with a multidisciplinary group: medical oncology, radiation oncology, gastroenterology, ostomy nursing, etc. Our goal is to provide high-quality, patient-centered care while continuing the mission of the residency. 

Resident / APP responsibilities:

• Always feel free to reach out to the attendings should there be an issue on the floor
• The team will round in the mornings on the service and communicate with the respective attendings by 7 am.
• Daily notes and orders should be completed in a timely fashion so that the patient’s care is not delayed
• IPHRs should contain relevant history and surgical indications. Ideally this would be performed the day before the OR
• Residents to send a EPA (SIMPL) evaluation after cases or ½ day in clinic (“one EPA a day”)
• ALL PATIENTS DISCHARGED WITH AN OSTOMY NEED HOME HEALTH NURSING (OTHERWISE THEY DO NOT GET OSTOMY SUPPLIES)
• PLEASE TEXT US AT THE BEGINNING OF THE ROTATION IF THIS IS THE FIRST TIME ON SERVICE

Chief Resident responsibilities

The Chief Resident is the leader of the service and is expected to run the service: rounding, staffing, floor management, consults, etc. In addition: 

• Assign cases a week in advance on surg.me
• Ensure residents get to clinic ½ day per week
• Assign an educational topic to be presented by junior / senior (alternating) and find a time to meet with the attending on call that week

Consults and admissions 

The residents or APP will see any consults and admissions. These should typically be staffed with the surgeon on-call, unless it is during the day and the patient is already well-known to another attending. 

Please send a message to the office for follow up appointments for all consults / transfers who were not seen in the clinic pre-op

Clinic

Residents are expected to be in clinic ½ day per week.  The resident will either see the patients first or at the same time as the attending. Anorectal physical exams should be performed with the attending in the room. Teaching will occur throughout the day. Typically, charting by the resident is not necessary. Our office is at 55 Spring street, Scarborough, ME.

OR

The residents should arrive to the OR prior to induction. They should assist with patient positioning as well as with setting up the room (monitors, etc). Knowledge of the relevant anatomy and general steps of the procedure are expected. Pre-op a discussion with the attending should occur identifying specific portions of the procedure that the resident should focus on (getting into the abdomen, docking the robot, mobilization of the sigmoid, splenic flexure mobilization, etc). 

Senior residents should be able to verbalize the critical steps of the operation

Endoscopy

These cases do not need resident coverage – however it is important that residents obtain the 50 required scopes by graduation. When residents participate, they are expected to check patients in before the procedure: gather relevant history, consent and write IPHR. 

Relevant history:

• Previous colonoscopies
• Previous hx of polyps
• Blood in stool
• Change in bowel habits
• PMHx
• Family hx
• Surgical hx
• Anticoagulation
• GLP-1 medications

Educational Mission

Growth in the understanding and technical skills required to treat colorectal pathology is expected. You will gain increasing responsibility and autonomy in the OR, Endo suite and floor in accordance to your skill level. 

Each week the residents on service will alternate and present an educational topic to the on-call attending. It is the chief resident’s responsibility to select the topic and timing with the on call attending. These should be brief, 5-10 min discussions (no power points). The first week new residents are on service, this will be a general orientation / expectations talk

Schedule