The third year is spent in the surgical section except for approved out rotations. During this year, concentration is on improving one's skill in the operating room along with continued guidance and training in surgical diagnosis.
The resident shall be progressively allowed to perform more complex major procedures as his ability and knowledge increase.
This year, the surgical resident is expected to do more teaching of the junior residents, interns, and clinical clerks. He or she is expected to aid in their training by both formal lectures and participating in informal bedside teaching.
The resident's personal training is progressive and targeted to perform major surgical procedures. This includes gallbladder surgery, surgery of the biliary ducts, gastric surgery, surgery of the spleen, pancreatic surgery, trauma team, thyroid surgery, gynecologic and breast surgery as well as large and small bowel surgery.
The resident's reading program should be extensive and emphasize the above surgical procedures and related pathologies.
The fourth-year resident rotates through the scrub services of the surgical section. In addition, one is accorded the privilege of "bumping" more junior residents on selected cases of special interest. When the Senior Surgical Resident elects to scrub a surgery not in his service, he or she is expected to see and evaluate the patient preoperatively, as well as assume the postoperative management of the patient under the attending surgeon's supervision.
Residents are discouraged from taking out rotations during the fourth year. This is the most important year of the clinical training program during which residents are expected to Simultaneously:
The correct syntheses of these disparate elements prepare the resident to enter practice as a competent and proficient surgeon.