Kaweah Delta Health Care District (KDHCD) is the primary site of the surgery
program. KDHCD is the only hospital in Visalia, a city of over 130,000
people, and with its 581 registered acute care beds is the largest one
in the county of Tulare. The county has a population of more than 440,000,
with a 20% increase between 2000 and 2010.
The full-service hospital has nearly 30,000 admissions and 5,000 deliveries
per year, with an average daily census in excess of 400 patients. KDHCD
is also the primary site of ACGME-accredited residency programs in Family
Medicine, Emergency Medicine, Psychiatry, Anesthesiology, and Transitional Year.
KDHCD has a total 14 operating rooms, which include three rooms with extensive
physiologic monitoring capabilities and a state-of-the-art hybrid room
for endovascular procedures. Two brand new trauma operating rooms came
online in 2017. Surgical volume is over 14,000 procedures a year, over
4,000 of them on inpatients. Approximately 8,000 endoscopies were performed
in the KDHCD’s endoscopy suite last year. KDHCD operates the only
trauma center in the counties of Tulare and Kings, serving a combined
population of nearly 600,000. Every year, KDHCD Emergency Department evaluates
and treats over 90,000 patients with more than 1,000 trauma activations.
To respond to the growing health care needs of the area it serves and because
of its commitment to graduate medical education, KDHCD continues to make
substantial investments to further upgrade its capabilities. The appointment
of a full time surgical faculty of 6, the completion of a heliport and
the extensive expansion of its emergency department that took place over
the last few years exemplify the magnitude of those investments.
The Fresno Veteran Affairs (VA) Medical Center is participating site of
the program. Nearly 1,800 surgical procedures were performed at the site
last year. Approximately 1,000 of the operations involved essential content
areas of general surgery, and the institution is actively expanding its
minimally invasive thoracic and bariatric capabilities. The VA rotation
augments the clinical experience of the residents in some of the essential
content areas of surgery as it provides not only a substantial increase
in volume and variety of the cases, but also an opportunity to manage
and deliver the continuum of surgical care in a population with unique
demographics and within a complex integrated system.
KDHCD surgery program provides the bulk of the volume and breadth of the
necessary operative experience in general surgery at its primary and integrated
sites, and each graduating resident will perform between 850 and 1,000
cases as a the primary surgeon, and at least 250 by the end of the second
year of training.
Specific outside rotations have been arranged through program letters of
agreement with the appropriate sites to give the residents exposure to
specialized content areas, such as pediatric surgery at the Valley Children's
Hospital in Madera, and transplantation, burns, and hepatic, biliary and
pancreatic surgery at University of California, Irvine Medical Center
in Orange. The program provides housing at all the rotation sites.