General Surgery  

Residency FAQ's

What programs are available? The University of Utah Department of Surgery offers a full spectrum of educational experiences in the Divisions of General Surgery, Neurosurgery, Orthopedics, Otolaryngology, Plastic Surgery, Thoracic Surgery and Urological Surgery. Residency training in each of these divisions is conducted within an ACGME approved program leading to board eligibility for that specialty. In addition to the categorical general surgery program, the General Surgery Division also offers one or two preliminary positions. These positions are intended to provide a broad background for individuals who desire preliminary general surgery training prior to entry into independently arranged specialty training programs.

How many interns do you accept? We have RRC approval for five categorical general surgery trainees. Five are admitted to the program each year with a plan to finish five chief residents from each group. Our attrition rate over the past 10 years has been approximately 17%. In addition to our categorical interns, 4 categorical Orthopedic, 3 categorical Otolarngology, and 2 categorical Urological interns are admitted by their respective programs.

Do you accept international graduates? Each year we interview several international graduates and usually place several on our rank list. We require the same admission standards of the international graduates as is required of American school graduates. Applications from all applicants must have the following essentials: a passing grade in Step 1 and Step 2 of the USMLE with no failed attempts, an ECFMG Certificate, proof of an acceptable visa, a transcript from medical school and three letters of recommendation from general surgeons who are familiar with clinical aptitude. All applications are accepted through ERAS.

What is the first year rotation schedule? The rotations are different for each subspecialty as dictated by the Program Director. For the General Surgery interns, there are 12 one-month rotations. Each intern spends ten months on core General Surgery rotations in Gastrointestinal, Transplantation, Vascular, Trauma, Burn, Pediatric and Cardiothoracic Surgery in three different hospitals.

What about call schedules and work hours? We are committed to an eighty hour work week. While we have made progress with physician extenders, cross coverage schemes and mandatory time off, we recognize that on occasion, educational benefits require working more than eighty hours. Our residents approach an eighty hour work week through the following policies: no in-house call is more frequent than every third night, every resident will average one day off/week averaged over 4 weeks (this is usually accomplished by having every other weekend off), and all post-call housestaff leave by noon the next day. Every General Surgery service has a nurse practitioner or physician’s assistant.

What about faculty contact? The faculty is readily accessible at all hospitals with essentially daily contact on the wards, in the operating room and in teaching conferences. When a junior trainee is operating as the surgeon at the University or in a private hospital, a faculty member is essentially always present during the case. When operating as the surgeon at the Veteran's Hospital, a first-year trainee is assisted by either faculty or chief resident.

How about patient volume? The University of Utah Affiliated Hospitals are in a period of unprecedented growth. The physical plant is expanding to accommodate increases in outpatient visits and operating room procedures. The University Hospital census is usually at 85% capacity. Over the years, the operative case load reported by our graduating residents has been better than more than 80 percent of the other programs in all of the principal defined categories of General Surgery. This case volume allows us to offer an early operative experience beginning in the first month of your first year. Our affiliated hospitals also have very busy surgical services that provide for a robust surgical experience throughout the residency.

What about patient care responsibility? On each service, the most junior members (preferably the intern or medical student) are expected to write the orders and perform the pre- and postoperative care on all patients. The clinical volume, particularly in the private hospital setting, ensure relatively liberal opportunity for junior housestaff members to function as first assistant and, on appropriate cases, as surgeon in the operating room.

Where is the training conducted? Housestaff at all levels rotate on University surgical services at the University Hospital, Veterans Administration Medical Center, and Primary Children's Medical Center. In addition, there are rotations at a private general hospital, the Intermountain Healthcare Hospitals. Approximately half of the first year is spent in the University/VA axis and approximately 75 percent of the total five-year experience is spent in the University and VA Hospitals.

Primary Children's Medical Center Website

Salt Lake City Veterans Medical Center Website

Intermountain Healthcare Website

Are there differences in emphasis at these hospitals? The University Hospital has undertaken a re-organization of the faculty and housestaff into services that are focused on specific disease processes. Rather than the traditional general surgery services which cover all areas, the University Hospital Services offer an in-depth experience in a curriculum driven approach, including, weekly literature based didactic discussions and ward rounds. The University Hospital Services are: Trauma, Transplant, Surgical Oncology (White Service), Colorectal, Gastrointestinal, and Minimally Invasive (Red Service), Emergency Surgery (Green Service), Burn Surgery, and Critical Care. The Primary Children’s Medical Center provides an unparalleled exposure to Pediatric Surgery with no fellow. The Veteran’s Adminstration Hospital provides smaller services with more direct responsibility on two services, vascular and general surgery. The LDS Hospital provides a private hospital experience with three high volume services, two are traditional general surgery rotations and one is a vascular surgery service.

How long is the training? The clinical portion of the general surgical traineeship is five years in length. Many residents spend a year in the lab making their training period six years. An occasional resident spends two years in the lab for a seven year residency. We finish no more than five residents per year.

Are you required to do a laboratory experience? A one-year research experience is available after three years of clinical training. Each year we have between one and three residents in the laboratory. A research year is strongly encouraged but not required. There are research opportunities within the Division of General Surgery as well as the Huntsman Cancer Institute. Residents who arrange research experiences at other institutions are granted a leave and return to the clinical training in the fourth year. Such arrangements must be funded by the host institution. We would be happy to explore the possibilities with you when you visit for an interview.

How do you evaluate housestaff performance along the way? Housestaff are evaluated at the end of each rotation by clinical preceptors. They are also evaluated in a quarterly evaluation meeting by all of the faculty and upper-level housestaff. The annual in-training examination is required. The results of these evaluation tools are given to the resident’s mentor who meets with the resident as often as necessary but at least once a year for an annual performance summary.

What kinds of surgical service rotations are involved? The series of rotations in which most junior residents participate include those with the following special emphasis: gastrointestinal and minimally invasive surgery, medical gastrointestinal disease, surgical endoscopy, endocrine surgery, thoracic surgery, vascular surgery, pediatric surgery, surgical oncology, transplantation, surgical critical care, burn surgery, trauma surgery, emergency medicine, orthopedics, plastic surgery, neurosurgery and urological surgery.

How about the operative experience? Because of the large volume of patient flow and the relatively large number of faculty to whom the chief or senior surgical resident and the team relate to on a teaching service, there is a relatively liberal opportunity for junior housestaff to function as first assistant, and often as surgeon, in the operating room. As an index of this early and continued operating experience, a general surgery resident usually finishes this program having counted oneself as "surgeon" on 1100 to 1300 cases. Approximately 300 of these cases are logged during the chief residency year. This distribution of operating experience seems optimal as defined by the Residency Review Committee. It stimulates a high interest and eliminates anxiety regarding technical development at the junior level and brings the chief resident to the final year with a level of technical expertise and confidence which allows one to also devote an appropriate amount of effort to patient care decision making, teaching responsibilities and administrative duties. The actual resident operative experience as reported to the RRC will be given to you at the time of your interview.

What about research opportunities? Participation in research activities during the training period is encouraged whenever an individual indicates an interest, but is not required. A number of active laboratories exist within the Department of Surgery, where basic research can be accomplished. A trainee may elect to work in an established laboratory or, with the help of the faculty, may develop a research project of their own. Surgical research resources which are available are many and diverse. These can be discussed at the time of your interview.

What do your chief residents do when they finish? Approximately 75 percent of our finishing chief residents go on to complete fellowship training. Approximately 25 percent go directly into general surgery practice. Approximately twenty percent eventually wind up in academic positions and the rest in private practice. With a few exceptions, all of our residents have been successful in securing fellowships of their choosing. We have not had problems with residents failing to pass the American Board of Surgery examination. Every finishing resident in the last 20 years that has taken the examination has passed it; ninety-five percent on the first try. The fact that our residents can leave here and go directly into the practice of general surgery in the private community suggests that our program is a complete educational experience in and of itself. In addition, our program prepares residents for highly competitive fellowships. A list of those fellowships will be provided to you at the time of your interview. Our philosophy, therefore, has been to provide a multi-tract program with the flexibility necessary to tailor portions of an individual's training to specific needs.

What about activities outside of the traditional training program? In addition to the patient care hospital activities and the educational conferences there are several regularly scheduled meetings outside of the hospital designed to enhance your development into a surgical practitioner. On the first Tuesday night of every month is the Salt Lake Surgical meeting. Residents are invited to attend this meeting on a regular basis. This fosters relationships with the local private surgeons and allows residents to get to know visiting professors in a less rigid atmosphere. On occasion, there are group outdoor activities which vary with the season. This past year we have skied, snowshoed, mountain-biked, road cycled and hiked in the adjacent Wasatch National Forest as a group.

What about the Salt Lake City area? The Intermountain West encompasses all of Utah and large portions of five surrounding states: Nevada, Idaho, Montana, Wyoming and Colorado. This is a vast region, encompassing almost a half million square miles with a population of about 3 million, of which only 3/4 million live in and near Salt Lake City on the Wasatch Mountain Front. It is probably the largest contiguous area in the U.S. whose tertiary medical care needs are served by a single metropolitan center, Salt Lake City. Because of this enormous "medical watershed" creating a flow of interesting referral cases to Salt Lake City and the very pleasant living conditions in Salt Lake, there has developed a higher concentration (per population density) of surgical specialists in this city than in most metropolitan centers in the country. Yet the population of Salt Lake City is only 400,000. Thus, as an environment in which to spend years of one's life in graduate surgical training, Salt Lake City offers all the advantages of a highly sophisticated medical community without most of the hassles of typical big city living. Salt Lake is a very convenient place to live. For around $700-1,000 per month one can find a pleasant apartment within 5-10 minutes of four of the affiliated hospitals in a neighborhood in which one would be happy to raise children and to stroll about the streets in the evening. Salt Lake is a cultural community. There is an excellent symphony orchestra and ballet company, opera, live theatre and a repertory dance theatre. Many consider the University of Utah to have the best school of dance, with a separate department for modern and ballet, between the coasts. Season tickets to most of these activities can be obtained for $300 or less, and five minutes before show time, one can park within a hundred yards of one's seat, all distinct considerations for busy housestaff. Despite these cultural advantages, neither housestaff nor faculty spend the largest portion of their free time at the opera. Although many come to Salt Lake as non-skiers and mountaineers, few leave as such. The Wasatch Mountains rise immediately to the east of the University Medical Center. It is a 35 minute drive from the University up through Little Cottonwood Canyon to Alta and Snowbird and a ten minute tram ride to 11,000 feet for a 3,000 foot vertical drop through "the greatest snow on earth." In the summer, it is a 20 minute drive from the University to begin climbing 11 and 12 thousand foot peaks. Kayaking and river running are also popular summer pastimes, easily pursued in the immediate environs.

Why should I choose Utah over other equally excellent training programs? Our sunshine, mountains and powder snow are certainly not the least of the assets of which we would make you aware. But for the serious student of surgery seeking that training program which will best meet his or her individual needs in graduate education, we would hope to leave your attention focused on that aspect of surgery training at the University of Utah which we consider to be our single greatest advantage over most other programs: There is an attitude and atmosphere of collegiality and cooperation. The residents that are here enjoy being here. We invite you to visit the University of Utah and experience this collegiality by spending some time with residents who are in the training program at the University of Utah Affiliated Hospitals.

How do I get around during my interview? Please see the "Contact Us" tab on the left for a link to maps of the area.