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The Department of Surgery was founded in 1974 together with the creation of the Stony Brook School of Medicine. Expanding on the institutional vision, the department’s mission is to achieve national recognition as a leading research entity; provide exceptional clinical care encompassing “leading edge” therapies and technologies to our patient population; serve as a first-tier educational program for our fellows, residents, students and staff; and play a leading role in our community in the dissemination of high-quality healthcare and education.
The department is organized into nine clinical divisions: general surgery, including trauma and surgical critical care; cardiothoracic surgery; otolaryngology-head and neck surgery; breast surgery; upper gastroenterological and general surgical oncology; pediatric surgery; plastic and reconstructive surgery; colon and rectal surgery; and vascular surgery. In addition, the department includes two nonclinical divisions: education and surgical research.
Medical Student Education
The department provides instruction for medical students throughout their four years of training. Most of the department’s effort is directed at third- and fourth-year students in the form of a general surgery clerkship and surgical selectives/electives, although some didactic teaching is also provided for the first- and second-year students through clinical correlations lectures. The cornerstone of the student education program is the eight-week Phase II clerkship (repeated eight times per year to encompass the entire Phase II class), which is offered at three sites (Stony Brook University Hospital, Winthrop-University Hospital, and the the Northport Veterans Affairs Medical Center).
Third Year
The third-year surgery clerkship is designed to provide the student with a broad experience in the the evaluation and treatment of patients with surgical disease across all of the general surgical disciplines via his/her assignment to a specific surgical team of residents and attending physicians. These rotations are geared to emphasize direct patient contact, including all phases of evaluation, diagnosis, and treatment. Students are specifically expected to: 1) participate in daily patient care until clinic follow-up, 2) accept personal responsibility as a physician for the care of their patients, acting always under attending and resident supervision, 3) obtain didactic learning through regular attendance of student lectures and department-wide educational activities, and 4) attend surgical skills labs geared to teach basic surgical technique.
The formative and summative evaluation of students include weekly meetings with the clerkship director at which regular feedback to the students is provided, a mid-point quiz, an Objective Structured Clinical Examination (OSCE), and a clinical evaluation by the attending and resident physicians with whom the student has had substantial contact. At the conclusion of the general surgery clerkship, the student also takes a “PBL” formatted oral examination and a standardized National Board examination, graded on a standardized national curve.
Fourth Year
There are a number of course offerings in the fourth year, one of which is mandatory (Surgical Selectives), and several which are electives (sub-internships in a number of services, and the surgical anatomy didactic course). The one-month Surgical Selectives course (including a mandatory two-week service in anesthesiology) provides student with additional exposure to optional rotations in the surgical subspecialties. The sub-internship in surgery allows the senior medical student to function as a primary responsible physician working under the close supervision of the surgical team.
Residency/Fellowship Programs
The Department of Surgery offers a five-year, ACGME-certfied residency program in general surgery graduating six chief residents per year, with a total of 51 residents. In addition, individual divisions within the department offer an ACGME-accredited residency plus fellowship in general, vascular, colon and rectal surgery, otolaryngology and plastic surgery in surgical critical care.
All residency/fellowship programs in the department require residents to develop the six competencies, as defined by the ACGME, in the following areas: patient care; medical knowledge; practice-based learning and improvement; interpersonal and communication skills; professionalism; and systems-based practice. To successfully complete residency/fellowship training, these competencies must be developed to the level expected of a new practitioner.
A Surgical Skills Center (SSC) is also available to provide residents and medical students with a more expanded educational curriculum. The SSC provides opportunities for trainees to practice in a stress-free environment not only surgical technical skills, but also pre-operative and post-operative patient care scenarios that enhance residents’ educational experience. The SSC utilizes cutting-edge audio/video technologies and software in order to maximize the utility and productivity of the activities it hosts and to provide opportunities for performance review of, effective debriefing with, and meaningful feedback to trainees.
Training modules range from basic open skills (knot tying, suturing, IV access, central line and chest tube insertion) and fundamental laparoscopic skills (camera navigation, controlled cutting, transfer drills, and laparoscopic suturing) to advanced open surgical skills (inguinal hernia anatomy and repair, sutured and stapled intestinal anastomosis, vascular anastomosis, arterial endarterectomy and bypass, open aortic aneurysm repair) and advanced patient care skills (advanced trauma and cardiac life support, various surgical clinical care scenarios). Three high-end haptic virtual reality simulators are also available for training in laparoscopic advanced skills, laparoscopic cholecystectomy, laparoscopic colon resection, angiographic vascular anatomy, and a wide array of basic and advanced endovascular skills (navigation of endovascular catheters, angioplasty, and stenting). A dedicated space for a surgical wet-lab has also been created to allow for practice using animal tissue.
General Surgery
The general surgery residency graduates six chief residents per year, and a total of 51 residents participating in a five-year, ACGME program across three campuses. General surgery residents are provided training predominantly by Department of Surgery full-time and voluntary faculty, but also rotate on the Department of Urology transplant service and receive additional endoscopy experience on the Gastroenterology Service in the Department of Medicine. As detailed below, the residents’ clinical rotations are supplemented by didactic conferences and simulation lab opportunities, as well as by opportunities to rotate out of their training for one to two year experiences in departmental, on campus or off-campus research endeavors.
Vascular Surgery and Endovascular Surgery
The department offers a five-year vascular and endovascular surgery residency and a traditional two-year fellowship. Based in the Division of Vascular and Endovascular Surgery, both training programs are designed to prepare physicians for the pursuit of either an academic or high volume private practice career in vascular and endovascular Surgery. Residents are chosen out of medical school for the integrated five-year program, which culminates in eligibility for primary certification in vascular surgery only while fellows have complete a general surgery residency and eligible for certification in both general and vascular surgery. For those physicians who are decided on vascular surgery as a career, this program provides focused training and reduces the amount of training time from the traditional training period by two years. Residents and fellows are taught the whole range of open and endovascular interventions from routine to complex, medical management of vascular disease, and use and interpretation of noninvasive vascular lab studies. Clinical research is an important part, and required, of both training programs in vascular surgery.
Colon and Rectal Surgery
The department offers a one-year colon and rectal surgery residency (fellowship) based in the Section of Colon and Rectal Surgery. The content of the educational experience is directed toward fulfilling the requirements of the American Board of Colon and Rectal Surgery. Fellows gain operative experience through a large volume of diverse surgical procedures, including reconstructive anorectal surgery, surgery for inflammatory bowel disease, emergency colon resections, ambulatory anorectal surgery, and all aspects of office and endoscopic procedures. Upon completion of the training program, fellows are ready to enter into clinical practice, and are eligible for board certification in colon and rectal surgery.
Otolaryngology-Head and Neck Surgery
The department offers a five-year residency program in otolaryngology-head and neck surgery. This residency is devoted to the task of educating and training physicians to function independently as specialists in the field. The program is based in Division of Otolaryngology-Head and Neck Surgery, and has met the rigorous standards set by the ACGME. It consists of a specialized year of rotations (i.e., six months of otolaryngology, one month of plastic surgery, one month of oral and maxillofacial surgery, one month of neurosurgery, one month of anesthesia, one month of surgical critical care, and one month of trauma surgery), followed by four years of otolaryngology-head and neck surgery. All rotations occur at Stony Brook University Hospital and the ambulatory and clinical facilities of the Division of Otolaryngology-Head and Neck Surgery. Upon completion of the residency, trainees are ready to enter into clinical practice, into fellowship training, or into basic medical or clinical research.
Plastic Surgery
The Division of Plastic and Reconstructive Surgery provides training of plastic surgery residents at Stony Brook Medicine, as an affiliated institution of the integrated six-year residency program of the Long Island Plastic Surgical Group (LIPSG) base at NuHealth (Nassau University Medical Center; NUMC) in East Meadow, NY. The program, fully accredited by the ACGME, trains residents in all aspects of surgery with specialization in plastic and reconstructive surgery, under the guidance and mentorship of faculty from all three organizations: NUMC, LIPSG, and Stony Brook Medicine. Residents have the unique opportunity to train in the large private practice setting of LIPSG, as well as at numerous other locations including NYU Winthrop Hospital and Mercy Medical Center in addition to Stony Brook University Hospital, Stony Brook Cleft Palate-Craniofacial Center, and Stony Brook Plastic & Cosmetic Surgery Center. The NuHealth LIPSG-Stony Brook plastic surgery residency program teaches the next generation of plastic surgeons everything from the basics of aesthetic enhancement procedures to reconstruction of skin in patients with severe burns.
Surgical Critical Care
The surgical critical care residency (fellowship) is a one-year experience (two fellows per year) centered at Stony Brook University Hospital, which is the only regional (Level 1) trauma center in Suffolk County. The fellows are provided clinical experience in surgical critical care, including burn care, and do rotations on the hospital’s specialized intensive care units. Fellows are actively involved in clinical research with members of the Division of General Surgery, Trauma, Surgical Critical Care, and Burns.
Research
The Department of Surgery is committed to its mission to achieve national recognition as a leading research entity. The department has developed an infrastructure to support both clinical and translational research and to foster research projects by both faculty and trainees. The surgery residency program has incorporated a robust curriculum in research education, including the teaching of literature review, hypothesis generation, study design, biostatistics, ethics in research, data analysis, and research proposal writing. As part of the training requirement, all residents must present or publish a paper in their first three years of training, with a second such project mandated for their fourth or fifth year.
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