Curriculum
The surgery program curriculum at Kaweah Delta consists of five years of
coordinated, progressive didactic and supervised clinical activities designed
to prepare the trainees to assume gradually higher responsibility and
autonomy in the care of surgical patients, and ultimately enter the unsupervised
practice of surgery.

Didactic activities
The following core didactic activities take place at the program's
primary site within a scheduled weekly 4-hour block of time protected
from clinical assignments:
- Grand Rounds
- Practice Based Learning and Improvement conference
- Basic science and clinical curriculum session
- Supervised simulation and skills lab session
- Journal club meetings
Additional rotation-specific didactic activities at the primary site, such
as Tumor board, Trauma and Vascular conferences, may occur outside the
protected time block. During off-site rotations, residents attend the
didactic activities available at that site.
Self-study programs based on online curricula and ad-hoc didactic sessions
or workshop address specific areas such as clinical research, fatigue
mitigation, patient safety, quality and performance improvement, communication
and teaching skills, professionalism, and cultural sensitivity.
Kaweah Delta Surgery program faculty and residents can access the current
didactic schedule on the password-protected New Innovations website (https://www.new-innov.com/Login/Login.aspx). A live calendar of the current academic year conference schedule is
also available
here.
Clinical activities
The vast majority of the clinical experience takes place at the program's
primary site and at the Fresno Veteran Affairs (VA) Medical Center, which
is an integrated site of the program. Specific off-site rotations are
arranged with the appropriate sites to give the residents exposure to
content areas in which it is anticipated that the program's main site
may not provide an adequate experience, such as pediatric surgery, transplantation,
burns, and complex surgical oncology, hepato-biliary and pancreatic surgery.
Housing is provided by the program at all the off-site rotations. Nearly
all the rotations include inpatient and outpatient assignments.
The clinical assignments of the first two years of residency are designed
to provide the trainees with a balanced exposure to all content areas
of surgery. Specific rotations in surgical critical care, transplant and
endoscopy offer clinical and didactic activities aimed at achieving the
competency expected of a general surgeon in those areas.
During the subsequent three years of training, the residents gain progressively
increasing knowledge and patient care skills in the following essential
content areas of surgery:
- Alimentary tract
- Abdomen and its contents
- Breast, skin, and soft tissue
- Head and neck, including trauma, vascular, endocrine, congenital and oncologic
disorders -- particularly tumors of the skin, salivary glands, thyroid,
parathyroid, and the oral cavity.
- Vascular system, excluding the intracranial vessels and heart.
- Endocrine system, including thyroid, parathyroid, adrenal and endocrine pancreas.
- Surgical oncology, including coordinated multimodality management of the
cancer patient by screening, surveillance, surgical adjunctive therapy,
rehabilitation, and follow-up.
- Comprehensive management of trauma, including musculoskeletal, hand, and
head injuries.
- Complete care of critically ill patients with underlying surgical conditions,
in the emergency room, intensive care unit and trauma/burn units.
Primary and integrated site rotations include General Surgery, Acute Care
and Trauma Surgery, Vascular Surgery, Critical Care and Surgical Endoscopy.
Off-site assignments include Burn, Hepato-biliary-pancreatic and Transplant
Surgery rotations at University of California, Irvine, and a Pediatric
Surgery rotation at Valley Children Hospital in Madera.
Subject to Kaweah Delta program director's approval, a four-week block
during the fourth year of training is available for elective rotations
at a site of the resident’s 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).