Introduction

Introduction:

The General Surgery Residency Program is located at Harlem Hospital Center, a Teaching Hospital of the College of Physicians and Surgeons of Columbia University. The hospital is accredited by the Joint Commission on Accreditation of Healthcare Organizations. Other fully accredited residency training programs within the hospital include Radiology, Internal Medicine, Pediatrics, Plastic Surgery, Child Psychiatry and General Psychiatry. The surgical program is integrated with the Department of Surgery at Woodhull Medical and Mental Health Center in Brooklyn (Woodhull Hospital). Dr. Soji F. Oluwole is the Director of Surgery at Harlem Hospital Center.  Dr. Albert K. Adu is the Program Director while Dr. Prashant Sinha is the Chairman of Surgery at Woodhull Hospital.

The surgical program is 5 years of clinical training during which residents are able to learn the fundamentals of basic science as applied to clinical surgery. Residents are exposed to pre-operative, operative, as well as post-operative and non-operative care of patients in all of the principal components of general surgery.

The program encourages the residents to participate in clinical and laboratory research. Residents are encouraged, especially before their senior years, to do basic science research at either Columbia University College of Physicians and Surgeons or another institution of their choice. The years spent in research are not counted as part of the clinical training and the Residency Review Committee is always informed of such research activities by residents. Scholarly activities like basic and clinical research, peer-reviewed publications, and presentations at local and national conferences strengthen the resident’s application for fellowships following completion of surgical residency training.

 

The training program is approved by the Residency Review Committee for the training of 24 residents with the breakdown as shown below:

 

       PGY I - 3 categorical residents, 7 preliminary residents

       PGY II - 3 categorical residents, 2 preliminary residents

       PGY III - 3 categorical residents

       PGY IV - 3 categorical residents

       PGY V - 3 categorical residents (chiefs)

All residents are informed in writing prior to entry into the program of their status in the program, the structure of the program, the length of the residency training, the duration of appointments and conditions for reappointments. All residents are members of the Committee for Interns and Residents (C.I.R.). The department and the hospital follow the Collective Bargaining Agreement reached between the Health and Hospitals Corporation of the City of New York and the CIR. The CIR organization serves as a medium for residents to address their concerns in a confidential and protected manner. Residents have representatives from the hospital who sit on the Board of the Committee to discuss and oversee the implementation of the bargaining agreement, which includes:

Wages of the residents
Individual contracts
Productivity
Health and Hospital benefits
Malpractice Insurance
Prohibition against discrimination
Work schedule
Grievance procedure
Disciplinary action
Vacation and leave time, etc.

The department is in agreement with the Goals of the ACGME that:

l. Residents are first and foremost students, rather than employees, and all accreditation standards and activities reflect this distinction.

2. Residents need to be protected as students with respect to their educational environment and the clinical settings in which they learn. There is appropriate security and personal safety measures in place in all locations in the hospital and related clinical facilities.

The program is made up of the parent institution, Harlem Hospital Center, and the integrated institution, Woodhull Hospital, each with a Director of Surgery. The Program Director oversees the integrated residency program.
 

Residents elect a representative who participates in the activities of the hospital’s GME Committee. The resident representative is a PGY II or above resident.
 

The Program Director in consultation with the Directors of Surgery at Harlem Hospital and Woodhull Hospital is responsible for the appointment of attending surgeons on the teaching staff in the parent and integrated institution and supervises the rotations of the attending staff in both institutions for teaching, instruction and supervision.

The Program Director designates well-qualified surgeons to assist in the supervision and mentoring of the resident staff so that, for each approved chief residency position, there is at least one geographic full-time teaching staff member whose major function is to support the residency program. These key staff members are appointed for a period long enough to ensure adequate continuity in the supervision of the resident staff.
 

The Program Director is responsible for the appointment of all residents in the program and determines the rotations and assignments of the residents.

There is a Residency Advisory Committee and/or Clinical Competence Committee (CCC) made up of the following:
The Program Director
The Director of Surgery (or designee) at each of the institutions 
Selected attendings
All Chief Residents

The Program Director and the Committee members meet periodically to discuss and implement various matters concerning the program such as:
• The general competencies and Milestones of residents
• Selection of candidates for the residency program
• Evaluation of residents
• Evaluation of the Program
• Reviewing the Goals and Objectives of the program
• Coordinating the Educational Goals
• Evaluation of the effectiveness of the program in Achieving its Goals
• Periodic Evaluation and Utilization of Resources available to the Program
• Evaluation of Financial and Administrative Support for the program
• Evaluation of Performance of Members of the Teaching Staff
• Evaluation of the Volume and Variety of Cases for Educational Purposes
• Working environment of the residents

The concerns of residents are addressed in a confidential and protected manner.
The Program Director and his associate track the residents' operative log monthly through use of the computerized program provided by the Residency Review Committee. These records are reviewed periodically with the residents.

The Program Director monitors residents’ working conditions and personal situation (including mental or emotional conditions which could affect performance or learning and any drug or alcohol-related dysfunction). The Program Director, the teaching staff and resident preceptors are always available for confidential counseling and psychological support to residents. Any training situation that consistently produces undesirable stress on residents is evaluated and modified.

There are institutional policies and procedures as well as contractual agreements which residents must be aware of. These are contained in the House Staff Manual, the CIR Agreement with the Health and Hospital Corporation and the Administrative Policy and Procedure Manual of the hospital and of the GMEC. The policies and procedures include the following:

• Leave of absence
• Liability insurance coverage
• Sick leave
• Physician impairment and substance abuse
• Sexual harassment
• Health and disability insurance
• Parental sick leave
• Resident recruitment/selection
• Resident appointment
• Resident evaluation/promotion
• Resident dismissal
• Non-renewal of resident contract
• Moonlighting
• Residency closure/reduction in size
• Disaster Preparedness
• Vendor Relationship.

For other policies please refer to the manuals.