Residency Training in General Surgery

FELLOWSHIPS

Basic Research

The Department of Surgery offers a broad range of opportunities, individually structured, for fellowship training in the surgical basic sciences. Research-focused fellowships that are available in several areas of study consist of one to two years spent in the laboratories of established investigators. These research years may be integrated into a resident's program generally after the second year of clinical surgical training, and allow him or her ample time to read, plan and develop a project.

This unique opportunity offers the surgeon-in-training a better appreciation of basic research, as it provides a hands-on experience that involves learning diverse techniques from simple pipetting in the laboratory to postulating a working hypothesis, writing a grant proposal and, ultimately, authoring a scientific paper. A valuable resource for fellows at the writing stages of their projects is the Department's editorial support service. Funding for projects is diverse, ranging from grants awarded to faculty members by the National Institutes of Health to grants awarded on an individual basis to fellows through various funding sources, such as the American Heart Association and the Diabetes Foundation.

The development of a research project or the participation in an ongoing research project by residents is based on the particular interests of the individual resident and the possibilities of the faculty preceptor. The faculty of the Department comprises not only clinicians but scientists with formal training in areas such as anatomy, physiology, and immunology. Several animal, human and in vitro models have been established by faculty members. Among ongoing active research projects in the Department at present are:

n Radiofrequency ablation in high-risk patients with stage 1a non-small cell lung cancer
n Use of proteomic analysis of serum samples for detection of non-small cell lung cancer
n Mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection with patients with N0 or N1 non-small cell carcinoma
n Prognostic significance of occult metastases in the patient with resectable non-small cell carcinoma
n Use of Novadaq SPY imaging technology to assess mastectomy skin-flap viability
n Assessment of patient-reported outcomes following post-mastectomy breast reconstruction
n Survey of closed-suction drain management and antibiotic prophylaxis in immediate breast reconstructive surgery
n Comparison of risks and complications in post-mastectomy tissue expander/implant breast reconstruction with and without acellular dermal matrix
n Comparison of standard sutures versus Quill sutures on cutaneous wound scarring
n Transanal hemorrhoidal dearterialization versus hemorrhoidectomy
n Strattice facial onlay to prevent parastomal hernia formation in patients undergoing surgery for permanent abdominal wall ostomies
n Laparoscopic-assisted resection versus open resection for rectal cancer
n Benefit of coenzyme Q-10 in patients on statins
n Gel-filled breast implant adjunct study
n Changes in muscle recruitment following treatment with botulinum toxin type A
n Acute venous thrombosis: thrombus removal with adjunctive catheter-directed thrombolysis
n Incidence of heparin induced thrombocytopenia over-diagnosis in hospitalized patients
n Determination of candidates for pharmacomechanical thrombolysis
n Nutritional regulation of albumin synthesis
n Role of visceral adipose tissue in inflammation
n Cellular mechanism for sarcopenia in the elderly
n Regulation of adipose tissue formation
n Mechanisms of remote ischemic preconditioning
n Compliance with treatment guidelines and effect on outcome in patients with melanoma
n Impact of melanoma treatment on physical and psychosocial function
n Genetic character of melanoma and correlation with outcome
n Role of lymph node surgery in patients with melanoma
n Early ambulation of patients in cardiothoracic surgery: efficacy and safety postoperatively
n Role of median sternotomy versus mini-thoracotomy in heart valve surgery
n Role of median sternotomy versus mini-thoracotomy in systemic inflammatory responses to open heart surgery
n Ten-year follow-up assessment of a phase 1 trial of angiogenic gene therapy for the treatment of coronary artery disease using direct intramyocardial administration of an adenovirus vector expressing the VEGF121 cDNA
n One-year follow-up of patients receiving the geoform annuloplasty ring for functional mitral regurgitation
n Impact of portable music players on hearing in children
n Indocyanine green fluorescence imaging as a prognostic indicator of optimal wound healing
n Linezolid in the treatment of subjects with nosocomial pneumonia proven to be due to methicillin-resistant Staphylococcus aureus
n Claudication: exercise versus endoluminal revascularization (CLEVER)
n Retrospective review of robot-assisted gastric resections
n Novel approach to the surgical management of distal pancreatic stump

The Surgical Research Laboratory based in the Department is made up of core facilities in which a variety of assays are performed (e.g., radioimmunoassay, enzymatic, fluorometric, and spectrophotometric assays), including assays with high-pressure liquid chromatography. Emphasis is placed on metabolic studies, in volunteers and patients, using stable isotopes and mass spectrometry. The laboratories used for conducting basic research are fully equipped and staffed for supporting a wide spectrum of research projects without compromising quality of results.

Basic research conducted by the surgical faculty and fellows is frequently published in peer-reviewed journals and presented at national and international meetings.

Surgical Specialties

The Department of Surgery also offers clinical fellowships in burns, colon and rectal surgery, surgical critical care, and vascular surgery.

Burns. The burn fellow is assigned to University Medical Center's Burn Center. The Center offers a unique opportunity for fellows to obtain specialized training in the care of burn patients. This includes initial assessment of the injury and resuscitation, intensive care and surgical management of the patient, and restoration of the individual to an acceptable level of quality of life. This one-year (unaccredited) fellowship also offers significant opportunities for clinical research in burns. Research in growing human skin for burn treatment is part of the Burn Center's effort to develop a unique living-skin bank. Other areas of specialized research involve the evaluation of artificial skin coverings for burns and also metabolic studies designed to re-evaluate the nutritional needs of burn patients.

Colon and rectal surgery. The Division of Colon and Rectal Surgery offers an accredited one-year colon and rectal surgery residency (fellowship). This training program is designed to prepare the surgeon for the pursuit of an academic career in colon and rectal surgery equally as well as for private practice in colon and rectal surgery. Please click here to see details about the program.

Surgical critical care. An accredited surgical critical care residency (fellowship) is available. This one-year residency is directed by Marc J. Shapiro, MD, interim chief of general surgery, trauma, surgical critical care, and burns. Clinical responsibilities emphasize the management of the multiply-injured and critically ill patient. In addition, the resident is expected to participate in basic or clinical research. For more information, please call 631-444-1045.

The following list provides information about the application process, as well as how to obtain the application form:

n Selection of critical care fellows is made through the Surgical Critical Care Section;
n All applicants must be board eligible/certified in general surgery;
n A personal interview is required;
n Applicants must have a New York State medical license by July 1 of the academic year they begin;
n Before the required interview takes place, three (3) letters of recommendation one of which must be from the chair of the applicant's department are to be sent to the program director, Marc J. Shapiro, MD, Department of Surgery, Health Sciences Center T-19, Stony Brook University, Stony Brook, NY 11794-8191;
n The application deadline is October 1 for the fellowship starting July 1 of the next academic year;
n Click here for the application form (you will need Adobe Acrobat Reader if you don't have it, download a free copy; it is quick and easy to install), which should be completed and sent to the program director at the address below, along with a copy of the applicant's curriculum vitae;
n Questions concerning the application process should be directed to Linda Brochhausen via e-mail or phone (631-444-1791) or fax (631-444-7689).

Life on Long Island

Vascular surgery. The Vascular Surgery Division at Stony Brook University Medical Center offers an accredited vascular surgery fellowship (plus five-year residency). This fellowship is designed to prepare the surgeon for the pursuit of an academic career in vascular surgery equally as well as for private practice in vascular surgery. The vascular surgery fellowship program was recently granted permission from the RRC to become a two-year fully accredited clinical fellowship.

The Vascular Surgery Division has five full-time vascular surgery faculty members: Antonios P. Gasparis, MD, medical director of the Non-Invasive Vascular Laboratory; Mazen M. Hashisho, MD; Nicos Labropoulos, PhD, director of the Non-Invasive Vascular Laboratory; David S. Landau, MD; and Apostolos K. Tassiopoulos, MD, interim chief of vascular surgery and program director of the vascular surgery residency. The vascular surgery faculty has broad expertise in the entire spectrum of vascular and endovascular surgical procedures.

The first year of the fellowship is spent rotating at Stony Brook, the VA hospital, and Winthrop. The fellow is expected to perform at least 100 major open cases as well as 100 diagnostic and/or therapeutic endovascular procedures. At the VA hospital, the vascular fellow is responsible of the non-invasive vascular laboratory studies. This experience allows the resident to qualify for the certificate of registered vascular technologist upon completion of the fellowship.

In addition, during the first year the vascular surgery fellow is expected to initiate clinical research projects, which should be completed before the end of his or her fellowship. The Department also offers ample opportunities for collaboration with faculty in basic research.

The second year of the fellowship is also spent rotating at Stony Brook, the VA hospital, and Winthrop. At least 300 major vascular reconstructions covering the entire gamet of abdominal, extremity, and neck interventions are expected during the second year. In addition, at least 300 diagnostic and therapeutic endovascular interventions are expected to be completed by the vascular surgery fellow, including aneurysm repair, peripheral arterial and carotid angioplasty and stenting, thrombolysis and venous intervention.

While general surgery residents rotate on the vascular services as junior residents and return again during their fourth or fifth years, the senior chief resident does not rotate on the same service with the vascular resident; thus, the general surgery resident in no way diminishes the surgical responsibility of the vascular resident on the vascular surgery services.

During the fellowship, the vascular fellow is expected to participate in the clinical education of the junior general surgery residents rotating on the vascular surgery service. The vascular surgery fellow is responsible for the preparation and direction of the vascular surgery conferences and a number of didactic clinical and basic science presentations. The vascular surgery fellow is allowed a large degree of independence in the operating room.

Upon completion of the training program, the fellow should feel comfortable in dealing with all aspects of clinical vascular surgery, and is eligible for board certification in vascular surgery by the American Board of Surgery.

If you have any questions regarding our training program, please do not hesitate to contact Dr. Tassiopoulos at 631-444-2683.

The following list provides information about the application process, as well as how to obtain the application form:

n Selection of vascular residents is made through the National Resident Matching Program;
n All applicants must be board eligible/certified in general surgery;
n A personal interview is required;
n Applicants must have a New York State medical license by July 1 of the academic year they begin;
n We are registered with the Electronic Residency Application Service (ERAS), which transmits residency applications, recommendation letters, dean's letters, transcripts, and other supporting credentials from medical schools to residency program directors using the Internet). Applications will only be accepted through this system.
n Questions concerning the application process should be directed to Linda Brochhausen via e-mail or phone (631-444-1791) or fax (631-444-7689).

Additional information about the residency/fellowships described above, as well as opportunities available for postgraduate training in the other surgical specialties at Stony Brook, can be obtained by writing to:

Linda Brochhausen
Administrative Director
Surgical Residency Program
Health Sciences Center, T-19, 020
Stony Brook University
Stony Brook, NY 11794-8191



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