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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 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 includes weekly meetings with a preceptor at which regular feedback to the students is provided, 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
The fourth-year course offerings are as follows: Surgical Sub-Internship, Surgical Electives, Advanced Clinical Experience in Surgery and Transition to Residency-Surgery (also known as Surgery Bootcamp).
The surgical sub-internship is a focused month designed to prepare students for post-graduate residency training. Students will participate directly in the daily care of surgical patients; i.e., initial evaluation, diagnostic work-up, formulation of differential diagnoses, formulation of treatment options and institution of management plans. It is important to emphasize that the student is expected to function at the PGY-1 level, with close supervision available from the resident and attending surgical team. Students will participate on rounds, daily care tasks, procedures, surgeries and conferences.
The surgery elective is a two-week course designed to gain exposure and experience in a specific surgical discipline. The surgical elective is time the resident should use to familiarize themselves with new specialties or services they may not have been exposed to during their third-year rotation on surgery. While less stringent than a Sub-I rotation, students are expected to perform at the level of an intern and to participate in the daily care and management of patients, as well as partake in OR cases and service specific conferences.
The goal of the Advanced Clinical Experience course in Surgery is to develop competence in the fundamentals of surgery and to expand the student’s proficiency in the evaluation, diagnosis and management of a variety of diseases and disorders of the surgical patient. This course is specifically designed for students who are interested in surgery or surgery-related fields of medicine and will provide practical experience to help aid students in their transition from senior medical student to surgical intern.
The Transition to Residency course is a two-week “boot camp” session consisting of various high-impact education sessions, clinical simulations sessions in the skills lab and anatomy work on cadavers. This course is directed toward students applying for or accepted into a surgical residency program and designed to improve student skills and confidence before graduation and starting residency.
Residency/Fellowship Programs
The Department of Surgery offers ACGME-certified residency training in General Surgery, Vascular (Integrated), Otolaryngology, Plastic Surgery (Integrated) and Podiatry. Additionally, the department offers advanced ACGME-accredited fellowship training in Colon and Rectal Surgery and Surgical Critical Care as well as non-ACGME-accredited fellowship training in Bariatrics/Minimally Invasive Surgery and Abdominal Wall/Hernia.
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 fellows with simulation-based education as part of the educational curricula. 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 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). Simulators are also available for training in basic and advanced laparoscopic skills as well as robotics. A collaboration with the Stony Brook Division of Laboratory Animal Resources provides opportunity for simulation-based education and skill development utilizing animate tissue.
General Surgery
The General Surgery Residency is a five-year ACGME-accredited residency program with general surgery training undertaken across four training sites (Stony Brook University Hospital, Stony Brook Southampton, Northport VA Medical Center and Good Samaritan Hospital). The program encompasses nearly 50 resident trainees and graduates seven chief residents, annually. General surgery residents are provided training and supervision by Department of Surgery full-time faculty as well as participating voluntary faculty at affiliate training sites (Northport VA Medical Center and Good Samaritan Hospital), but also gain further operative experience rotating in the Department of Urology transplant service and the Otolaryngology service. In addition to the clinical rotations and experiences, the general surgery residency training is augmented by the didactic curriculum and associated conferences, as well as simulation-based education (inanimate and animate labs).
Additionally, there is flexibility for trainees to pursue career development opportunities (1-3 years) outside of clinical training (research, etc.) to augment their development and preparation for the next phase of their career (fellowship training or practicing surgeon).
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 completed a general surgery residency and are 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 Division 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 open, laparoscopic and robotic major abdominal surgery; surgery for inflammatory bowel disease, malignancy and benign diseases; reconstructive anorectal surgery, 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 offers a six-year Integrated Plastic and Reconstructive Surgery Residency Program, which provides eligibility for certification by the American Board of Plastic Surgery. The integrated residency program will accept one new resident per year for a total of six residents.
The program is unique in its diversity of clinical experience. The first three years are concentrated at Stony Brook University Hospital (SBUH) where residents rotate through various services including plastic surgery. During the final three years, residents will broaden their plastic surgical experience to include time at New York Plastic Surgery Group (NYPSG), NuHealth, Northwell Health, NYU Winthrop Hospital and Mercy Medical Center, in addition to SBUH, Stony Brook Cleft Palate-Craniofacial Center and Stony Brook Plastic and Cosmetic Surgery Center.
Residents obtain both broad and in-depth exposure to the various surgical diseases embodying plastic surgery. Additionally, the training experience exposes residents to different teaching sites and faculty including academic practice and community-based practices encompassing all the forms of plastic surgery from cosmetic to reconstructive.
Podiatric Surgery
Stony Brook Medicine offers an integrated three-year Podiatric Surgery Residency Program fully accredited by the Council of Podiatric Medical Education through 2020. Our training program is designed to prepare physicians for the pursuit of an academic career in podiatric surgery as well as for private practice in podiatric surgery.
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 a 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. Residents have the opportunity to shadow principal investigators and learn how to conduct industry-sponsored clinical trials, which will help expand their research portfolios. 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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