General Surgery Rotations

The following rotations are currently included in the Kaweah Delta surgery residency program curriculum:

  1. Acute Care and Trauma Surgery 
  2. General Surgery 
  3. Vascular Surgery
  4. Hepato-pancreatic-biliary and Transplant Surgery 
  5. Burns
  6. Surgical Critical Care
  7. Anesthesiology
  8. Pediatric Surgery

The duration of each rotation is provided for reference only and may be subject to change to reflect the residents' individual educational needs and interests. An additional 1-block elective rotation is available, at the discretion of the program director, for PGY 4 residents at a site of their choice. 

Kaweah Delta Surgery program faculty and residents can access the current block schedule and the incremental goals and competency-based objectives of every rotation for each year of training on the password-protected New Innovations website (https://www.new-innov.com/Login/Login.aspx).  

 

Acute Care and Trauma Surgery 

Site Kaweah Delta Health Care District Hospital (Primary Site)

PGY level 1, 2, 3, 4, 5 

Total blocks 22

Clinical Subject

A. Evaluation and operative and non-operative, inpatient and outpatient management of patients with:

  1. Blunt and penetrating trauma of the head, torso and extremities
  2. Acute surgical conditions affecting head and neck, breast, skin and soft tissues, thorax, abdomen and alimentary tract, the genitourinary tract, the endocrine and the reproductive system  

B. Surgical procedural experience covering all the essential common and uncommon operations and some complex operations inclusive but not limited to:

  1. Open and laparoscopic exploration of the abdomen
  2. Open and laparoscopic hernia repairs
  3. Open and laparoscopic hepatic, biliary and pancreatic  surgery  
  4. Open and laparoscopic surgery of esophagus, stomach, small and large bowel, rectum and anus
  5. Surgery of breast, skin and soft tissues

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General Surgery 

Site Kaweah Delta Health Care District Hospital (Primary Site)

PGY level 1, 2, 3, 4, 5 

Total blocks 22

Clinical Subject  

A. Evaluation and operative and non-operative, inpatient and outpatient care of adult and pediatric patients with conditions in the following essential content areas of surgery:  

  1. Alimentary tract
  2. Abdomen and its contents
  3. Breast, skin, and soft tissue
  4. Head and neck, including trauma, vascular, endocrine, congenital and oncologic disorders -- particularly tumors of the skin, salivary glands, thyroid, parathyroid, and the oral cavity.
  5. Endocrine system, including thyroid, parathyroid, adrenal and endocrine pancreas.
  6. Surgical oncology, including coordinated multimodality management of the cancer patient by screening, surveillance, surgical adjunctive therapy, rehabilitation, and follow-up

B. Surgical procedural experience covering all the essential common and uncommon operations and some complex operations inclusive but not limited to:  

  1. Open and laparoscopic exploration of the abdomen
  2. Open and laparoscopic hernia repairs
  3. Open and laparoscopic hepatic, biliary and pancreatic  surgery
  4. Open and laparoscopic surgery of esophagus, stomach, small and large bowel, rectum and anus
  5. Surgery of breast, skin and soft tissues
  6. Surgery of the endocrine organs
  7. Surgery of head and neck
  8. Open and percutaneous surgery of the vascular system
  9. Endoscopy of the gastrointestinal and respiratory tract  

C. Evaluation and management, inclusive of a limited  procedural experience,  of patients for whom a general surgeon may be called to provide initial care in the following non-essential content area of surgery:

  1. Neurological Surgery
  2. Cardiothoracic Surgery
  3. Otolaryngology
  4. Genito-urinary Surgery
  5. Orthopedic Surgery
  6. Gynecology

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Vascular Surgery

Site Kaweah Delta Health Care District Hospital (Primary Site)

PGY level 1, 2, 4

Total blocks 6

Clinical Subject 

A. Evaluation and operative and non-operative, inpatient and outpatient care  patients with conditions affecting  vascular system, excluding the intracranial vessels and heart, including but not limited to :

  1. Arterial occlusive disease
  2. Aneurysmal disease
  3. Visceral occlusive disease
  4. Thromboembolic disease
  5. Venous disease Vascular trauma  

B. Surgical procedural experience covering all the essential common and uncommon operations and some complex operations inclusive but not limited to:    

  1. Vascular bypass procedures
  2. Endovascular procedures
  3. Aneurysmal repairs, open and endovascular
  4. Visceral vascular procedures
  5. Vascular injury repairs
  6. Venous procedures
  7. Vascular access procedures

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Hepato-pancreatic-biliary and Transplant Surgery 

Site University of California, Irvine Medical Center

PGY level 1, 2, 3

Total blocks 4

Clinical Subject 

 A. Evaluation and operative and non-operative, inpatient and outpatient management of patients with:

  1. Benign and malignant surgical hepato-biliary disease   
  2. Benign and malignant surgical pancreatic disease
  3. Solid organ transplant

B. Surgical procedural experience covering all the essential common and uncommon operations and some complex operations inclusive but not limited to:                                                  

  1. Open and laparoscopic liver surgery                                                  
  2. Open and laparoscopic biliary tree surgery  
  3. Open and laparoscopic pancreatic surgery   
  4. Transplant surgery  

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Burns

Site University of California, Irvine Medical Center

PGY level 2

Total blocks 1

Clinical Subject 

A. Evaluation and operative and non-operative, inpatient and outpatient management of adult and pediatric patients with burns of various extent and severity   

B. Surgical procedural experience covering all the essential common and uncommon operations and some complex operations inclusive but not limited to:

  1. Wound care Debridement and grafting
  2. Escharotomy
  3. Arterial line placement
  4. Pulmonary artery catheterization
  5. Bronchoscopy  

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Surgical Critical Care

Site Kaweah Delta Health Care District Hospital (Primary Site)

PGY level 1, 2

Total blocks 3

Clinical Subject  

A. Evaluation and care of critically ill patients in the following essential content areas of surgery

  1. Alimentary tract
  2. Abdomen and its contents
  3. Breast, skin, and soft tissue
  4. Head and neck, including trauma, vascular, endocrine, congenital and oncologic disorders -- particularly tumors of the skin, salivary glands, thyroid, parathyroid, and the oral cavity
  5. Vascular system, excluding the intracranial vessels and heart
  6. Endocrine system, including thyroid, parathyroid, adrenal and endocrine pancreas
  7. Surgical oncology, including coordinated multimodality management of the cancer patient by screening, surveillance, surgical adjunctive therapy, rehabilitation, and follow-up

B. Clinical experience covering all the essential, common decision-making and interventions required by the critically surgical patients, inclusive but not limited to:

  1. Airway establishment and maintenance
  2. Mechanical respiratory support
  3. Fluid an electrolyte balance correction and maintenance
  4. Management of acute blood loss
  5. Acute pharmacological support and management of cardiac and circulatory functions
  6. Acute support and management of renal function
  7. Acute support and management of nutritional function
  8. Complex wound care
  9. Complex surgical infections
  10. Neurological function assessment and monitoring
  11. Endoscopy of the respiratory tract
  12. End-of-life and palliative care

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Anesthesiology

Site Kaweah Delta Health Care District Hospital (Primary Site)

PGY level 2

Total blocks 1

Clinical Subject   

A. Preoperative anesthesiology evaluation and management of patients undergoing general and vascular surgery procedures under: general anesthesia monitored anesthesia care local and regional anesthesia  

B. Procedural experience covering all the essential interventions leading to establishing anesthesia inclusive but not limited to:  

  1. Obtaining peripheral and central IV access
  2. Placement all necessary non-invasive monitoring devices on patients in the operating room
  3. Induction of anesthesia, and mask ventilation prior to placement of the selected airway device
  4. Insertion and placement verification of airway devices (oral and nasal airways, endotracheal tube and laryngeal mask airway) with both Miller and MAC blades
  5. Establishment of proper mechanical ventilation settings  

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Pediatric Surgery

Site Valley Children's Hospital, Madera

PGY level 3

Total blocks

Clinical Subject

A. Evaluation and operative and non-operative, inpatient and outpatient management of pediatric patients with congenital and acquired surgical conditions affecting head and neck, breast, skin and soft tissues, thorax, abdomen and alimentary tract, the genitourinary tract, the endocrine and the reproductive system  

B. Surgical procedural experience covering all the essential common and uncommon pediatric operations and some complex pediatric operations inclusive but not limited to:

  1. Open and laparoscopic exploration of the abdomen
  2. Open and laparoscopic hernia repairs
  3. Open and laparoscopic hepatic, biliary and pancreatic  surgery
  4. Open and laparoscopic surgery of esophagus, stomach, small and large bowel, rectum and anus
  5. Surgery of skin and soft tissues
  6. Surgery of the endocrine organs
  7. Surgery of head and neck