Thoracic Surgery Service Expectations

Thoracic Surgery Service Resident Expectations – Updated Sept. 2017

PGY4:

Thoracic Service:

Coordinate rounds with APP’s and residents

Make weekly schedule with Melissa for case coverage, and daily/timely staffing with attendings

The following is expected in working with the APP’s:

- Use Thoracic Oncology list found under Service Groups - Surgical

- Add consults by adding the attending as a consultant (this will auto populate pt to our list)

- Pick up pager and obtain sign out from night resident

- 6:30am meet APP's on R1 in charting room for rounds

- With APP's split up writing notes/discharges once rounds complete

- With APP's split up consult follow ups to be seen on other floors and confirm plan(s) prior to writing notes on these consult pt's

- Once rounds complete head to operating room, clinic, or mandatory conference as appropriate for that particular day

- Pass service pager to APP prior to heading to clinic or conference and pick back up upon return

- Pass service pager to night resident and provide appropriate sign out - prior to signing out confirm overnight plans on any complex patient with the attending or APP as appropriate

 

Thoracic Education:

Prepare for cases, particularly anatomy and steps of the operation.  Ideally cases covered by residents would be discussed with the attending the day prior to set case specific goals and expectations.

Gain proficiency at bronchoscopy and bronchial anatomy

Imaging interpretation, CXRs and CT scans

Know and understand esophageal and lung cancer work up, staging and treatment options.

Differential diagnosis for mediastinal tumors.  Tumor markers.  Germ cell and thymomas in particular

Level appropriate cases: VATS pleurodesis, wedge resection, decortication.  Laparoscopic foregut.  Planned progression to lobectomies, mediastinal work with experience.

 

 

PGY2:

Thoracic Service:

Participate in daily rounds and floor care

The following is expected in working with the APP’s:

- Use Thoracic Oncology list found under Service Groups - Surgical

- Add consults by adding the attending as a consultant (this will auto populate pt to our list)

- Pick up pager and obtain sign out from night resident

- 6:30am meet APP's on R1 in charting room for rounds

- With APP's split up writing notes/discharges once rounds complete

- With APP's split up consult follow ups to be seen on other floors and confirm plan(s) prior to writing notes on these consult pt's

- Once rounds complete head to operating room, clinic, or mandatory conference as appropriate for that particular day

- Pass service pager to APP prior to heading to clinic or conference and pick back up upon return

- Pass service pager to night resident and provide appropriate sign out - prior to signing out confirm overnight plans on any complex patient with the attending or APP as appropriate

 

Thoracic Education:

Management of atrial fibrillation

Become comfortable with bronchial anatomy

Imaging interpretation, CXRs and CT scans

Prepare for cases, particularly anatomy and steps of the operation.  Ideally cases covered by residents would be discussed with the attending the day prior to set case specific goals and expectations

Know and understand esophageal and lung cancer work up, staging and treatment options

Differential diagnosis for mediastinal tumors.  Tumor markers.  Germ cell and thymomas in particular

Level appropriate cases: VATS pleurodesis, wedge resection, decortication

 

 

Key Topics in Thoracic Surgery:

Esophagus: Cancer and Barrett’s, dysmotility disorders (achalasia, diffuse esophageal spasm, nutcracker), diverticula (zenker’s, epiphrenic, midesophageal), paraesophageal hernias

Lung: Cancer, infection (abscess)

Pleura: Effusion, empyema, pneumothorax

Mediastinum: Tumors, compartments (anterior, middle, posterior)

Chest wall: Tumors