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Teaching, Learning and Scholarly Activity in Residency

The best test to determine if you really know something well is to teach it to another person. While surgical education doesn’t begin at the start of residency, it doesn’t end their either. Our commitment to education encompasses the whole spectrum, from medical students through to continuing education for seasoned faculty members.

Our hospitals serve as the primary teaching institutions for medical students of the University of South Carolina School of Medicine and our residents are entrusted to significantly contribute to the education of these students. Medical students rotate on services that are led by residents, including the general surgery services, the vascular service, and the trauma service. Education of the students is expected during daily rounds, in the operating room, and in didactic sessions and conferences.  

Additionally, the residents help run a bi-monthly trauma skills session at our affiliated simulation center. In this environment, students are taught trauma resuscitation interventions such as chest tube and central line placement. Critically, residents learn the art of debriefing and are coached in ways to become effective educators of adult learners.

Faculty members are offered regular opportunities for continuing medical education and faculty development. All faculty members are invited and encouraged to attend any of the resident lectures, grand rounds, and morbidity and mortality conferences.  

Just as there is no one right way to learn, there is no one right way to teach, and we encourage our residents to teach in a variety of ways. Traditional intraoperative “pimping” still can have value under the right circumstances, but others find didactic sessions, informal group discussions, hands-on teaching during surgery, or one-on-one interactions more effective. We hope that you too will be able to experience the joy of teaching a medical concept and then watching that student independently apply that knowledge to a clinical scenario.

Scholarly Activity

Residents are encouraged and expected to pursue scholarly activities during their residency. These activities can take the form of quality improvement projects, assisting with the writing of book chapters and other texts, traditional clinical or outcomes-based research, or additional pursuits at the program director’s discretion.
Understanding the process of medical and surgical research is paramount for any surgeon. While not every surgeon is expected to become a prolific research author, it remains incredibly important to have some basic understanding and experience of research for continued learning and development throughout your entire surgical career. For this reason, research is a mandatory part of our residency training and supported in a variety of ways.

Faculty interest in clinical and basic science investigation is diverse and all members welcome resident participation. Opportunities exist and residents are encouraged to develop their own particular research interests and design their own projects. The USC School of Medicine Basic Science Divisions, in addition to the clinical faculty, offer substantial resources and expertise to assist the resident in bringing their ideas to fruition.
Any resident with an abstract accepted for presentation at a local, regional, or national conference has the full support of the department and is excused to present at that conference with departmental funding.

Some of the recent research topics by our current residents includes:
  • Minimally Invasive Adrenalectomy outcomes
  • ERAS Opiate Usage QI project
  • Splenic and Liver Trauma Guidelines for PHR Website
  • Acquired Hemophilia Case Report
  • Thoracostomy and Antibiotic Usage in Reduction of Empyema Study
  • MEN1 and MEN2A & 2B Syndromes
  • Antibodies from multiple sclerosis brain identified Epstein-Barr virus nuclear antigen 1 & 2 epitopes which are recognized by oligoclonal bands
  • Can Planned Traffic Patterns Improve Survival Among the Injured During Mass Casualty Motorcycle Rallies?
  • Melt-Blown Poly Lactic Acid as A Tissue Engineering Scaffold
  • Dual Intragastric Balloon for Endoscopic Weight Loss
  • The PEWS, Can It Be Safely Used to Triage the Traumatically Injured Pediatric Patient? A Quality Improvement Initiative
  • Laparoscopic Sleeve Gastrectomy in Patients with Preexisting Gastroesophageal Reflux Disease: A National Analysis.  
  • Removal of cervical collars in ethanol positive patients with negative CT scans
  • Cryoablation as a pain control adjunct in surgical rib fixation
  • Unplanned returns to the ICU QI project
  • Review of Blunt Gastric Injuries
  • Tube feed use in hemodynamically unstable patients on high dose vasopressors
  • Tissue expander infection  
  • Incorporating audio/visual learning into surgical training, residents as teachers
  • Risk factors for delayed splenic bleeds in non-op management of splenic injuries
  • Addressing opioid prescription patterns in our program
  • Racial differences in severity and treatment of breast cancer
  • Triple negative breast cancer, recurrence rates following positive margins following lumpectomy

Quality Improvement

Residents are expected to be continually engaged in quality improvement (QI) projects throughout their training.  All residents complete the Institute for Healthcare Improvement (IHI) basic certificate during their intern year to achieve a baseline education on QI work.  Additional education can be coordinated upon request through the hospital’s Lean training programs.  

Many students and residents ask us “what’s the big deal with QI work, anyway?”  An excellent question! During residency training, a large amount of time is devoted to studying and technical development. That said, we need to continually evaluate the work we are doing and learn to view our surgical care in the context of a system of healthcare delivery. How can we make that system safer? How can we make it more efficient? More effective? These are incredibly challenging questions to answer, but the tools needed to answer them are best developed during residency, and not at some yet-to-be-determined time in the future. Just like everything else in surgery, training QI work is a learned skill, and the more we practice it the better we will become at it.  

Our residents and faculty have led numerous QI projects in the past, some in conjunction with the School of Medicine’s QUEST program (Quality Education and Systems Training) – an experiential training program that places multidisciplinary learners on active and mature QI teams. Some examples of recent projects include limiting opioid prescriptions after surgery, improving flow through the trauma bay, and reducing readmissions to the STICU.