Clinical Training

Our graduates finish with about 900 major cases done as surgeon, with 250 completed by the end of the second year and 200 done in the Chief year. Because of our unique and diverse training sites, our residents perform a broad range of basic general surgery cases and receive extensive experience in more complex cases such as liver resections, major pancreatic and esophageal resections, thyroid and parathyroid resections, state-of-the-art training in breast disease and surgical oncology, colorectal and advanced laparoscopic surgery. Below is a brief description of how we structure our clinical training to prepare our residents to enter independent practice and highly competitive fellowships.

First Year

The R1 year focuses on initial patient evaluation in the clinic, ICU and emergency room and perioperative care across a wide variety of disciplines. Rotations include acute care surgery, trauma, surgical oncology, colorectal, vascular, thoracic, and pediatric surgery. These services are rounded out with experiences in emergency room trauma, critical care, burn surgery, and plastic surgery. On all of these services, the R1 assists in operations on his/her patients and performs appropriate operative procedures. Our R1’s perform approximately 150 cases and procedures.


Second Year

The R2 concentrates on the fundamentals of critical care, with primary responsibility in the University of Washington CTICU and the Harborview Trauma ICU. Rotations on various other services, such as transplant surgery, surgical oncology, acute care surgery, and vascular surgery and the general surgery service at Northwest Hospital broaden this experience. The R2 performs operative procedures that build on the skills learned in the first year. By the end of the R2 year our residents have performed a minimum of 250 cases procedures.

Third Year

The R3 year commences the senior resident years.  Residents spend the year solidifying general surgery experiences at the VA and UW Medical Center, where advanced laparoscopy and bariatric surgery is the focus. At Harborview, the R3 functions as the primary trauma surgery consultant and leads the trauma ward service in conjunction with a Chief resident. A rotation as a senior fellow in medical gastroenterology augments the R3’s knowledge and expertise in upper and lower GI endoscopy. The R3 also serves as the chief resident on the burn surgery, pediatric surgery and Northwest Hospital general surgery rotations.  These chief-level rotations introduce the R3 to administrative and team leadership roles.


Fourth Year

With the operative experience, leadership skills and surgical maturity gained during the R3 year, the R4 focuses on a more complex surgical experience. Rotations on general surgery, advanced GI and hepatobiliary surgery, surgical oncology, colorectal surgery and advanced laparoscopic surgery at UW and vascular and thoracic surgery at the VA and Harborview provide meaningful and rewarding clinical experiences.

Fifth Year

The Chief resident year provides major responsibility in patient care, leadership, teaching, and administrative areas.  Chief residents perform the most complex operative procedures and assume responsibility for the operative and supportive care of all surgical patients at each of our major teaching hospitals. As leaders in the program, they also participate extensively in the education of medical students and residents, clinical investigations, and in departmental and service administrative matters.