Clinical Rotations
"I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow"
-The Hippocratic Oath
We're fortunate at BUMC to gain exposure to and training in a variety of surgical specialties. These are some of the rotations our residents take part in over the course of their residency training. All of our rotations are 6 weeks long, and we are spread across 3 main hospitals as well as satellite centers.
Trauma and Acute Care Surgery
This rotation takes place at both BUMC and JPS. At BUMC, we work with attendings from the Urgent Surgical Associates (UrSA), so the rotation is often called "URSA". At JPS, the team is always fielding trauma cases, since there's no division of resident services there like there is at BUMC. During the trauma rotation at both hospitals, we learn how to manage operative and nonoperative trauma. Our senior residents function as the team leader during resuscitations, as well as teaching junior residents in the operating room. Both BUMC and JPS are level one trauma centers, so we are busy at both locations.
​
The acute care part of the rotation includes all forms of surgical emergencies. Everything from appendicitis, cholecystitis, perforated viscus, hernias, wounds, and intraabdominal sepsis fall under the umbrella of ACS.
​
We spend time on a trauma/ACS service during every year of our residency.
Minimally Invasive and General Surgery
The MIS/ gen surg rotation takes place at BUMC. This rotation includes bread and butter general surgery, bariatrics, and minimally invasive surgery. We also do a lot of foregut surgery and hernia repairs on this service. This is where the bulk of our robotics training takes place at BUMC. We have attendings who are experts in robotic hernia repair, bariatric surgery, cholecystectomy, and foregut procedures. We also learn how to do foregut procedures like fundoplication, PEH repair, and gastric procedures using traditional laparoscopy. Our MIS attendings also give us exposure to endoscopic therapies like POEM and endoluminal vacuum therapy with endosponge.
​
This rotation takes place during 2nd, 4th, and 5th year
Surgical Oncology and Hepatopancreaticobiliary Surgery
This rotation at BUMC gives us a chance to perform oncologic surgery on most body systems, as well as teaches us how to work these patients up preop and how to manage their care postop. In addition to surgical management for skin cancer, sarcomas, intraabdominal cancers of all types, breast, and endocrine cancers, we also get to work with an ENT group to learn how to manage cancers of the head and neck. The ENT exposure is a particular boon for our residents and gives us experience with procedures most general surgery residents don't get to do very often. We attend multidisciplinary tumor conferences throughout the week, and we also have education conferences throughout the rotation led by the attendings and breast fellows.
​
On the HPB side, we perform surgeries for both benign and malignant processes affecting the liver and pancreas. We are lucky to work with attendings on the cutting edge of research, which allows us exposure to multiple techniques. We are involved in large open surgeries like Whipple procedures, as well newer procedures like robotic partial hepatectomy.
​
This rotation takes place during 1st, 2nd, 4th, and 5th years
Vascular Surgery
Our vascular rotation at BUMC puts us on a busy service at the Baylor Heart and Vascular hospital. We work with 2 fellows on the service, but there's more than enough cases to keep everyone busy. The service gives us a chance to do bread and butter procedures like dialysis access and angiograms, as well as more complex cases like endarterectomy, TCAR, and endovascular aortic repair. We work 1 on 1 with the attendings during this rotation, which really gives us a chance to learn from people who are undisputed leaders in their field.
​
There are daily conferences in the mornings, as well as larger multidisciplinary conferences (such as aortic conference) throughout the week.
​
This rotation takes place in 2nd, 3rd, and 4th year
Colorectal Surgery
This 4th year rotation at BUMC gives us a chance to take part in laparoscopic, robotic, and open surgical management of colon and anorectal conditions. We also spend time in the outpatient setting as well, performing colonoscopies and going to outpatient clinic with our attendings. There are multidisciplinary tumor conferences during this rotation, too, as we manage the surgical treatment of colorectal cancers as well as inflammatory bowel disease.
Transplant Surgery
BUMC has a very active abdominal transplant program, and we get to rotate on this service during our 3rd year. We scrub into kidney, liver, and pancreas transplants, and the attendings are all invested in getting residents involved in cases. As a result, residents are often able to perform all critical steps of a kidney transplant by the end of their rotation. We take donor call during the rotation, as well, which gives us a chance to see some amazing anatomy and learn how to perform exposures that we can take with us to other rotations.
Pediatric Surgery
This rotation takes place at Cooks Children's hospital in Ft. Worth. We get to work with a busy pediatric surgery practice, and since there are no fellows we scrub into a large variety of procedures, both laparoscopic and open. We also round in the neonatal ICU, giving us a chance to take part in both operative and nonoperative management of the tiniest of patients.
This rotation takes place in 1st and 4th year
Cardiothoracic Surgery
This BUMC rotation takes place in 4th year, and gives us a chance to see and participate in a variety of procedures above the diaphragm. We spend 4 weeks on thoracic, and then 2 weeks on cardiac. By the end of the rotation, most residents are comfortable performing a sternotomy, thoracotomy, and performing thoracoscopic procedures. We also get the chance to scrub into lung and heart transplant procedures, and most residents get some exposure to ECMO cannulations and decannulations.
Surgical Critical Care
We have 2 ICU rotations. One takes place at JPS during 2nd year, and the other is at BUMC in 3rd year. Both rotations have us managing the care of critically ill surgical and trauma patients in an intensive care setting. We work both day and night shifts, which gives us a chance to experience two very different environments. Both ICUs do multidisciplinary teaching rounds during the day, which gives us a chance to learn about all aspects of critical care for these patients. Though not an operative rotation, it is procedural in that the residents perform most of the bedside procedures these patients need. The attendings during our ICU rotations at both BUMC and JPS are the trauma attendings, so we already have good working relationships with them prior to the rotation. This gives us a chance to really take an active role in creating and executing treatment plans for these critically ill patients.
JPS Rotation
John Peter Smith Hospital in Fort Worth is a recurring rotation that takes place during every year of residency. This is the county hospital for Tarrant County, serving the needs of a diverse patient population. The rotation is true general surgery, providing an invaluable experience for the residents. In one 24 hour call shift, we may perform a hemicolectomy for colon cancer, a cholecystectomy, an appendectomy, a hernia repair, an exploratory laparotomy for trauma (or several), a vascular case, and a wound debridement. Several of our attendings perform robotic surgery, giving us a wealth of experience at the operative console. We also cover thoracic surgery at this hospital, giving us experience in open and thoracoscopic procedures.
​
JPS also provides the residents with the chance to run our own clinic, following their patients through all stages of their surgical care. It gives us a real ownership of our patients, and allows us to provide true continuity of care.
​
During 2nd and 5th year, we spend a rotation at JPS where we perform scheduled cases, instead of taking call. We work with attendings performing endocrine, breast, surgical oncology, HPB, thoracic, and vascular cases. This rotation is heavily operative and tends to be a favorite of the residents.
Baylor Waxahachie Rotation
Baylor Waxahachie is a newer rotation to our residency. The first group of residents went out there in 2019. The hospital is located about 25 miles from Dallas and is a 112 bed community hospital. The rotation has become a favorite of the residents because of the variety of cases and the amazing quality of the teaching staff. We are part of a busy general surgery service, performing both bread and butter cases as well as complex robotic hernia repairs, foregut procedures, and vascular surgery. We participate in all aspects of surgical care, both pre and post op, as well as taking call along with the attendings. We get a wealth of experience during this rotation in a different setting from an urban trauma center, which gives us a taste of what life is like in different practice models. The attendings are amazing and are fully invested in resident training and education. They welcome us into the operating room as well as into their private clinics, and they host educational conferences for us during our time there.
​
This rotation takes place during 2nd, 3rd, and 4th year