Teaching Conferences & Rounds

agnew

“The Agnew Clinic” by Thomas Eakins, 1889.D. Hayes Agnew was a respected surgeon who taught at the medical school of the University of Pennsylvania.

One of the primary educational goals of the surgical residency program is to foster an atmosphere of critical thought and self-improvement in all resident teaching activities. All teaching conferences, rounds, and symposia stress the principles of practice-based learning.

Protected Academic Time:

Lecture day occurs weekly alternating Wednesday and Thursday. The schedule is a defined curriculum with one hour of joint lecture, followed by an hour of conferences split into junior and senior resident sessions. Participation by each surgery faculty member in lectures or case conferences is expected six to eight times per year. Reading, Multimedia and testing materials are assigned before the sessions using AccessSurgery from McGraw-Hill. A third hour of teaching is sometimes included for smaller group skills acquisition, which is also added intermittently for longer sessions in the simulation center on Friday. Floor pagers and consult pagers are covered by mid-level providers during academic conferences, to avoid lecture disruptions.

Morbidity and Mortality Conference (all integrated and affiliated institutions):

This conference is held weekly at all integrated and affiliated institutions. Critical evaluation of the management of cases is stressed in this forum. The Chief Residents or R4/R3 residents present the selected cases from their respective services. Cases are selected for educational value as an important part of the quality improvement program of the hospital.

Surgical Grand Rounds (all integrated and affiliated institutions):

Grand Rounds are monthly and attended by all surgery faculty, residents, medical students and affiliated staff. A subject of surgical importance is presented and discussed in depth by experts in the field who are usually visiting from outside the institution.

lecture

An anatomy lecture at Boston University School of Medicine in the late 1800s.

Morning Report (BMC):

This conference is held each Wednesday morning by the Chief of Surgery at the East Newton Pavilion (BMC) and on Tuesday mornings by the Chief of Acute Care & Trauma Surgery at the Menino Pavilion (BMC). All inpatients and challenging cases are presented. Management decisions are reviewed and discussed.

Surgical Quality Improvement Conference (BMC):

This conference occurs monthly. The conference discusses initiatives by the Department of Surgery to improve outcomes and the quality of care for surgical patients.

Surgical Simulation Curriculum:

Twice a month on Mondays, residents participate in simulation-focused learning at our state of the art Solomont Simulation Center. The curriculum is focused on mastering both technical and non-techical skills such as procedural skills, suturing, bowel and vascular anastomoses, foundations of laparoscopic surgery, advanced laparoscopic and open gastrointestinal surgery, endoscopic skills, and teamwork/communication. Each level of resident has a separate and specific curriculum, lead by expert faculty members, providing ample opportunity for one-on-one, hands-on coaching. Curriculum content is routinely assessed and modified based on resident skill need and requests. The simulation center is available to residents for additional practice 24 hours a day, 7 days a week.

Visiting Professorship Programs (BMC):

Each year the Department of Surgery sponsors a variety of visiting professorships in the areas of Trauma (Clowes Visiting Professorship), Vascular Surgery (The Smithwick Visiting Professorship), and Surgical Oncology (The Mozden Visiting Professorship). In addition, the Grasberger Research Symposium is held each spring.

Each of the professorships takes place over a two-day period, during which the visiting professor interacts with residents and students in a variety of settings, including clinical rounds, clinical seminars, case presentations, and scientific seminars. Attendance is mandatory for all surgical residents, and elective surgery is limited during the visiting professorships.

Vascular Conference (BMC):

Vascular conference is held weekly by faculty members of the Smithwick (Vascular) service. Open and endovascular cases are presented by the residents and fellows. Management of the cases is discussed.

Acute Care & Trauma Surgery Conferences (BMC):

Acute Care & Trauma Surgery Morbidity and Mortality (M&M) Conference:
The Section of Acute Care & Trauma Surgery M&M is held every Tuesday and includes residents, fellows, mid-level providers and attendings who discuss all cases of morbidity or mortality that have occurred over the prior week. Each case is discussed in detail, including a review of some pertinent evidence-based medicine. Some of these cases will in turn be presented the following week at the Department of Surgery Morbidity and Mortality (M&M) Conference.

Trauma/Emergency Department Grand Rounds:
The Department of Emergency Medicine residents present two formal monthly trauma case reviews to the Emergency and Acute Care & Trauma Surgery department staff. A thorough review of the literature is included during each presentation. Aspects of prehospital care, emergency department management and surgical care is discussed in detail.

Trauma Video Conference:
The Section of Acute Care & Trauma Surgery gives at least one formal trauma case presentation monthly before an audience of Emergency Department and Acute Care & Trauma Surgery staff. In addition, there is a video/audio connection with staff from Lahey Clinic Medical Center and Good Samaritan Hospital. Lahey Clinic staff also present one trauma case in a similar format. Each case presentation includes evidence-based discussions, review of the trauma literature, and outcome discussions.

Weekly Academic Conference:
Each week, there are two hours of lectures given to the surgical residents. Every couple of weeks, one of these hour-long conferences will include a trauma or acute care surgical case. Issues of diagnostic work-up and management decision-making are discussed in detail.

Surgical Critical Care Conferences (BMC):

Critical Care Lecture Series:
Each Wednesday, the Surgical Critical Care section presents critical care lectures as part of the continuing curriculum in the fundamentals of Surgical Critical Care. A variety of critical care topics are reviewed and presented by the multidisciplinary team.

Daily Brief Lecture:
Every morning the ICU attending and/or surgical critical care fellow provides a brief lecture on a pertinent topic prior to the start of rounds. This provides a forum for additional structured education to supplement the case-based teaching during comprehensive patient rounds.

Critical Care Journal Club:
Each Wednesday, the critical care fellows review and present two journal articles. After critique of the articles, the critical care attendings, nurse practitioners, and fellows discuss current practice and potential for improvement/changes in practice based on the best evidence.

Multidisciplinary Critical Care Conference:
Each month, the surgical critical care, pulmonary critical care, anesthesia, and neurocritical care teams meet for a topic review/presentation and/or discussion of current literature.

Surgical Oncology Conferences (BMC):

Multidisciplinary Breast Cancer Conference:
This is a weekly multidisciplinary breast cancer conference in which the entire team collaborates on a comprehensive evaluation, and plans the best, most individualized treatment regimen and follow-up care for patients with breast cancer. There is ongoing communication with the patient and his or her primary care provider—so everyone is kept up to date and informed.

Hepatobiliary Conference
The Hepatobiliary Conference is held every other week and is a working conference at which six to twelve patients with hepatobiliary tumors are discussed. Diagnostic and therapeutic issues are discussed and management decisions are made by the multidisciplinary group.

Thoracic Oncology Conference
This is a weekly multidisciplinary conference where patient cases of lung cancer, esophageal cancer, and other thoracic malignancies are reviewed, and treatment plans generated. Clinical trial accrual is discussed at each meeting. Occasional didactic and research talks are also incorporated.

Boston Veterans Affair Medical Center (BVAMC) Conferences:

  1. Morning report daily from 7:00 AM to 8:00 AM: conducted by the Chief of Surgery at the Boston Veterans Administration Medical Center (BVAMC), is attended by all faculty and residents. All cases currently on the surgical service are reviewed. Residents must demonstrate a critical understanding of the data available on each case as well as be able to justify current management.
  2. Resident curriculum conference: The ACS chapters assigned for that week are reviewed and discussed in a round table format session
  3. Quality improvement conference: All complications, deaths, readmissions are discussed within the context of processes and systems of care to identify areas for potential practice based improvement based on best possible evidence.
  4. Pre-operative conference: Preparation of the surgical patient, choice of surgery and planned postoperative care are discussed in details on scheduled General surgery cases by residents and faculty over lunch every Friday.
  5. Multidisciplinary tumor board: Complex cancer patients are presented at this forum every other week.
  6. Combined GI/Surgery conference: Complex GI cases are presented at this conference attended by GI specialists and general surgeons . This conference takes place every other week.
  7. Grand Rounds; Presented weekly.

Research Symposia and Conferences

Resident Research Update/Grasberger Research Symposium (BMC):

The Grasberger Research Symposium is an annual research event that provides an opportunity for the surgical residents, faculty and staff to present original basic and clinical research. Read more about the Grasberger symposium.

Workshops

Mock Oral Examinations

Mock Oral Examinations are given each year to the PGY3, PGY4 and PGY5 General Surgery residents and are designed to prepare residents for the certifying examination of the American Board of Surgery.