Surgery

• Program Info
• R-1 Surgery
• R-2 General Surgery
• R-2 Orthopedics
• R-2 Reading List
• R-3 Rotation
• R-3 Reading List

Program Information (back to top)

Faculty:     Chris Vincent, M.D.

                    386-2857 or e-mail cvincent@sfm.fammed.washington.edu

Resident Chairperson (2003-2004):     Marci Putnam, M.D.

Didactics

There will be six Tuesday afternoon lecture days assigned for the surgery curriculum. In general, we attempt to cover general surgery, trauma, outpatient surgery, and various surgical subspecialties in an 18-month rotation. This assures that all residents will have 2 opportunities to cover the material. Specific conference titles and speakers are chosen by the surgery committee and chairhead.

Swedish First Hill Family Medicine first year residents will rotate for 2 weeks with James Hanson, MD and John Dawson, MD.

First year family medicine residents need to have experience in evaluating patients with breast diseases, especially breast cancer. They also need to learn surgical skills such as proper tissue handling, instrument handling, and suturing.

The R-1 will be responsible for the work-ups on the cases to which s/he is assigned. S/he will write the history and physical exam, orders, and progress notes. S/he should round on and care for these cases on which s/he has assisted to learn aspects of post-op care.

Residents are encouraged to become proficient in fine needle aspiration of breast masses. Supervision by Drs. Hanson or Dawson while performing such procedures is required.

At the end of the two week rotation Dr.'s Dawson and Hanson will be asked to fill out a brief evaluation form for the resident.

During this rotation residents will be in their own continuity clinic 2 half days a week and will be expected to attend Tuesday afternoon didactics every week. The remaining 7 half-days per week should be spent with Dr.'s Hanson and Dawson. Residents may not take vacation or CME during this two week rotation but may take vacation or CME for one of the remaining two weeks of the block.

a) Knowledge: The resident will be required to know the following about the most common breast surgery problems (eg. Breast Cancer, Mastitis, Benign Breast Mass):

i. Usual history, signs and symptoms of complaint

ii. Confirmatory physical, lab and X-ray findings

iii. Treatment alternatives, i.e., surgical vs. medical

iv. Pre-operative routines

v. Surgical and post-op complications

vi. Expected post-op routines: analgesia, physical activity, and drain and dressing routines as applicable

vii. Expected length of stay in hospital as applicable

viii. Suture removal and follow-up, if possible

ix. Rehabilitation instructions, including return to work or physical activity and long term functional issues

b) Skills:

i. Perform pre-op history and physical; interpretation of data base

ii. Perform basic knot tying and suturing

iii. Perform proper assistant maneuvers to facilitate the surgeon

iv. Perform surgical draping and dressing application

v. Write post-op orders and progress notes

vi. Communicate accurately with the patient, family and surgeon

c) Attitudes:

i. Recognize the indications for surgical intervention

ii. Identify the basic steps and roles in the surgical consultative process

iii. Learn to function in the surgical-primary care physician team

iv. Know the ethics of informed consent

v. Be able to disclose the operative findings to the patient, and show appropriate sensitivity when discussing life threatening illnesses (eg. Breast Cancer)

The address and phone for Dr.'s Dawson and Hanson is:

1221 Madison #1220

Seattle, WA 98104

Phone: 206 682-4790

R-2 General Surgery (back to top)

Second year family medicine residents need to have experience in evaluating patients with a variety of common surgical problems. While most family physicians will not be doing major surgery in practice, residents should become adept at first assisting and routine surgical techniques. They also need to refine surgical skills such as suturing and proper technique for handling tissues and instruments.

The R-2 will be responsible for the work-ups on the cases to which s/he is assigned. S/he will write the history and physical exam, orders, and progress notes. S/he should round on and care for these cases on which s/he has assisted to learn aspects of post-op care.

Residents are encouraged to become proficient in procedures such as thoracentesis, central lines and chest tubes. Supervision by Dr. Wilke while performing such procedures is required.

During this rotation residents will be expected to attend Tuesday afternoon didactics every week. The remaining 9 half-days per week should be spent with Dr. Wilke. Residents will take call with Dr. Wilke and are expected to assist him at surgeries when on call.

Residents will not have their own continuity clinic during this rotation but will be expected to "make up" clinic time during the remaining two weeks of the block. Residents are excused from covering their own OB patients, teen clinic, and taking FP Service "float" call during this two-week rotation but maybe asked to "make up" call or OB coverage during the remaining two weeks of the block.

Residents may not take vacation or CME during this two-week rotation but may take vacation or CME for one of the remaining two weeks of the block. At the end of the two week rotation Dr. Wilke will be asked to fill out a brief evaluation form for the resident.

a) Knowledge: The resident will be required to know the following about the most common general surgery problems (eg. Appendicitis, Cholecystitis, Bowel Obstruction, Abdominal Trauma, Inguinal Hernias):

i. Usual history, signs and symptoms of complaint

ii. Confirmatory physical, lab and X-ray findings

iii. Treatment alternatives, i.e., surgical vs. medical

iv. Pre-operative routines

v. Surgical and post-op complications

vi. Expected post-op routines: analgesia, feeding, NG & IV tube care, fluid and electrolyte balance, bladder and bowel care, physical activity, and drain and dressing routines as applicable

vii. Expected length of stay in hospital

viii. Suture removal and follow-up, if possible

ix. Rehabilitation instructions, including return to work or physical activity and long term functional issues

b) Skills:

i. Perform pre-op history and physical; interpretation of data base

ii. Perform basic knot tying and suturing

iii. Perform proper assistant maneuvers to facilitate the surgeon

iv. Perform surgical draping and dressing application

v. Write post-op orders and progress notes

vi. Communicate accurately with the patient, family and surgeon

c) Attitudes:

i. Recognize the indications for surgical intervention

ii. Identify the basic steps and roles in the surgical consultative process

iii. Learn to function in the surgical-primary care physician team

iv. Know the ethics of informed consent

v. Be able to disclose the operative findings to the patient

Contact and Scheduling Information:

The address and phone for Dr. Christian Wilke is:

 

1801 NW Market #301

(Adjacent to SMC Ballard)

Contact: Lisa (back office)

Or Pam (front office)

(206) 782-7441 voice

(206) 784-9664 fax

Dr. Christian Wilke's Schedule: