General Surgery Residency Program at VBMC

Message from the Program Director

The Nuvance Health General Surgery Residency Program offers exposure to a variety of surgical services and procedures to prepare graduates to excel in varied fields. Our program offers pioneering advanced procedures and quality care, including the following:

  • Minimally laparoscopic and robotic surgery
  • Modern bariatric care
  • Comprehensive surgical oncology services with dedicated surgeon-led teams in breast, gastrointestinal, liver/pancreas, thoracic, head/neck, melanoma and gynecologic oncology
  • High-volume hepatobiliary and pancreatic services that emphasize minimally invasive liver surgery
  • Hyperthermic intraperitoneal chemotherapy (HIPEC), hyperthermic intrathroacic chemotherapy (HITEC) and isolated limb infusion (ILI), one of the few hospitals to offer these services
  • Multidisciplinary airway program
  • High quality breast surgery program including reconstruction
  • Progressive endovascular and open vascular surgery
  • Comprehensive cardiac surgery program
  • Multidisciplinary wound management and hyperbaric program
  • Trauma and acute care surgery program

Our residents receive high quality training with an emphasis on early operative experience and incremental patient care responsibilities. We incorporate a curriculum utilizing state-of-the-art facilities that balance traditional surgical management with technology services, including the following:

  • Innovative simulation center
  • IBM Watson integration
  • Inpatient and ambulatory electronic medical record (EMR)
  • Picture archiving and communication system (PACS) medical imaging
  • da Vinci Surgical Systems and more

The new Patient Pavilion at Vassar Brothers Medical Center will add 15 operating room (OR) suites, an innovative conference center and private rooms for an enhanced patient care and educational experience. Vassar Brothers is also a Level II Trauma Center.

Our dedicated faculty is energetic, engaged and passionate about teaching clinical excellence. Our goal is to form a collegial environment, making resident wellness a priority while emphasizing patient care. We understand a modern, strong, comprehensive residency training program should work in concert with resident health and well-being. Each resident is matched with a faculty mentor, with a 1:1 faculty-to-resident ratio. There is a strong support system to ensure residents are part of the family at Nuvance Health. Currently, we do not have surgical fellows, so all teaching efforts and operative exposure are dedicated to our resident staff.

We are seeking good people with the potential to be great physicians, and well-rounded surgeons and clinicians. In your search for a residency program, we can offer opportunities to structure training in pursuit of career paths in community-based general surgery, academic settings and specialized fellowship training. All residents engage in scholarly activity, focusing on research, quality improvement and outcomes-based practice.

We take pride in our clinical performance, our facilities and our training program, and we are extremely thankful for the great community we have at Nuvance Health. We hope you’ll consider joining us.

Dr. James Nitzkorski
Program Director
General Surgery Residency Program


For questions or more information, contact Program Manager, Maggie Forte margaret.forte@nuvancehealth.org or (845) 790-1311

 

 

 


Statement on Diversity

The Department of Surgery at Nuvance Health – Vassar Brothers Medical Center is committed to fostering a culture that reflects the incredibly rich diversity of our community and of the patients we treat. The Department of Surgery welcomes individuals of all backgrounds, cultures and individual differences regardless of ethnicity, gender, race, religion or sexual orientation.

We are committed to inclusion, and we believe that a diverse academic community enhances our ability to treat our patients and train our medical students and residents.

Program Structure

The Nuvance Health General Surgery Residency Program is structured to ensure residents participate actively in a wide range of cases from all surgical specialties. Each rotation is structured in blocks, fully immersing trainees in the surgical specialties to which they are assigned.

 

Training sites include:

Vassar Brothers Medical Center (VBMC) – Poughkeepsie, NY Vassar Brothers Medical Center | Nuvance Health

Nearly all time during the residency will be spent at VBMC.  Rotations include:

-General Surgery, MIS & Robotics

-Colorectal Surgery

-Trauma, Critical Care

-Acute Care Surgery and Consultation

-Surgical Oncology (Liver/Pancreas, GI, Melanoma)

-Head/Neck including reconstructive surgery and free flaps

-Breast Surgery

-Vascular Surgery

-Thoracic Surgery

-Endoscopy

-Palliative Care

 

Northern Dutchess Hospital (NDH) – Rhinebeck, NY  (Northern Dutchess Hospital | Nuvance Health)

-Bariatric Surgery rotations

 

New York-Presbyterian/Columbia University Medical CenterNew York, NY (New York-Presbyterian/Columbia University Irving Medical Center (nyp.org)

-PGY-2 residents rotate on the Pediatric Surgery service for one month

-PGY-3 residents rotate on the Liver Transplant service for one month

 

Cooper University – Camden, NJ (Level 1 Trauma Center | Cooper University Health Care (cooperhealth.org)

-PGY-4 residents are currently assigned one month on the Level 1 Trauma Surgery service.

 

Housing is provided for rotations at Columbia and Cooper.

 

An example of one resident’s training in this program is shown below. This is just an example and may be adjusted by the program director to ensure adequate experience, case log numbers and ACGME compliance.

Rotation colors are based on teams and coverage of service lines.

All surgical services are supported by an outstanding team of surgical PAs

 

 

Academic Offerings

Residents’ Journal Club

As a first step in learning how to effectively practice evidence-based medicine, interns and residents participate in Journal Club to appraise a recent study published in the medical literature. Each intern presents at least once at Journal Club.

Tumor Board

The purpose of the Health Quest Tumor Board is to educate multidisciplinary physicians and ancillary staff who treat or manage cancer patients. Cancer conferences improve the care of cancer patients by contributing to the patient management process and outcomes, and by providing education to physicians in attendance.

Boot Camp

As a new resident, you will participate in an intern boot camp during your first week here. This will help you adjust to residency life and provide you with an overview of programs, topics and required information. Non-patient care/medical knowledge SCORE Curriculum topics are covered as well, including interpersonal communication skills, professionalism, systems-based practice, and practice-based learning and improvements.

In-Service Training Exam

ABSITE In-Training Exam

Residents’ medical knowledge and clinical reasoning will be benchmarked for measuring longitudinal growth through the results of the annual American Board of Surgery In-Training Exam. All general surgery residents will complete the exam. Results will be reviewed with the program director to inform discussions and individualization of curriculum and clinical training (e.g., reading material, board prep and electives).

Academic Half Day

Most didactic experience occurs on Thursday mornings. Residents enjoy protected time to focus on the educational aspects of residency. Mandatory conferences are held regularly in the Nuvance Health General Surgery Residency Program. The following lecture schedule applies to the program, and attendance by residents and faculty is required.

All lectures are designed to provide residents with a broad range of knowledge on the ACGME competencies and the SCORE Curriculum concepts.

M&M

Weekly, 7 am Thursdays

SCORE

Thursdays

Program Director’s Conference

Informal case discussions and board review scenarios, Thursdays

Multidisciplinary Tumor Conference

Breast – Tuesdays 7:30 am

Thoracic – Tuesdays Noon

Rectal/Upper GI – Wednesdays 7:30 am

Head/Neck – Thursdays 7:45 am

Service Rounds

Daily each morning before first cut with the supervising faculty, chief resident, charge or OR nurse, and other pertinent members of the patient care team.

Grand Rounds

Monthly topics cover a wide range of medical and surgical subjects.

Schwartz Rounds

Quarterly, system-wide conference dedicated to wellness. Recent topics included “Nurturing Resilience in Ourselves and Others” and “Injustice and Bias in Healthcare.”

Wellness

 

Residents who are well make excellent physicians. The importance of wellness is emphasized throughout the residency program.  Some of the things we have done to promote wellness:

 

  • Peloton exercise bike located in the Surgical Resident Call Room
  • Strict adherence to 80 hour work-week (plus NYS duty hour restrictions)
  • Annual welcome party for incoming residents
  • Newly refurbished Call Room space
  • Collegial and mutually respectful atmosphere
  • System-wide Schwartz Rounds
  • Access to mental health and employee assistance program
  • Anonymous program feedback options
  • Faculty “open door” policy
  • Residency-sponsored events such as
    • Hiking and Axe throwing event
    • Apple picking
  • NEW for 2023/2024 academic year:
  • Resident-Only Gym installed (located within VBMC) with free weights, rack, yoga mats, treadmill
  • 5th Thursday Program:  When a “5th Thursday” of the month occurs, residents are dismissed immediately following didactic sessions.  Residents are encouraged to use the time for wellness activities and attend personal appointments such as primary care visits, etc

 

 

Curriculum Design

Curriculum Design

 

Feedback from residents has been critical to our success so far.  Our residents meet with our Faculty and Program Director frequently to review our program, and changes have been made to optimize the quality of the educational program at VBMC.

For example, new changes for the 2023/2024 academic year the VBMC residency program include:

  • A formal PGY-2 rotation in Palliative Care, making VBMC one of the only surgical training sites in America to designate a formal palliative care rotation.

 

  • A formal PGY-4 rotation in Trauma Surgery was established at Cooper University (housing provided) to supplement our Level-2 trauma experience at VBMC.

Research and Quality Improvement Opportunities

Each resident pairs with a faculty mentor who offers encouragement and support. Mentors assist residents in background research, feasibility, Institutional Review Board (IRB) approval, study design, implementation and analysis, and quality improvement projects.

General surgery residents are encouraged to present all research within the department, locally, regionally or nationally, including during the annual Nuvance Health Program Resident Research Day, when residents in all specialties may present posters and oral presentations showcasing their work.

Clinical Trials

Residents have access to a quality assurance officer who assists in the development and implementation of all quality improvement projects. In addition to each resident’s project mentor, the quality assurance officer serves as an excellent resource for residents to use when working on quality improvement projects and implementation or analysis.

Residents are also supported by the quality assurance team committee at each training location. This experience provides residents with the ability to see quality assurance and improvement issues and solutions from a hospital perspective.

Residents are also provided with access to NSQIP, a surgical de-identified registry of all procedural cases that compares data between teaching hospitals across the nation. This serves as another great resource for residents to find data and conduct robust clinical research. This data is stored on a cloud-based library. In addition to NSQIP, residents have access to registries such as VQI and STS.

Operative Experience

Operative Experience:

Early and Robust operative experience with proper supervision and teaching is emphasized.

Interns typically log between 150-200 cases during their first year in the residency.  Our Chief residents have an incredible operative experience.

This is a representative example of ACGME-required major case volume for our Chief residents starting their PGY-5 year.

Category ACGME Minimum

Resident  1

Resident 2

Resident 3

Skin and Soft Tissue

25

25 26

28

Breast

40

23 32

37

    Mastectomy

5

17 25

29

    Axilla

5

6 5

5

Head and Neck

25

27 36

68

Alimentary Tract

180

259 295

227

    Esophagus

5

10 6

10

    Stomach

15

79 55

32

    Small Intestine

25

28 36

31

    Large Intestine

40

86 103

69

    Appendix

40

39 74

60

    Anorectal

20

17 21

25

Abdominal

250

197 359

220

    Biliary

85

92 178

99

    Hernia 85 46 98

62

    Liver

5

15 32

18

    Pancreas

5

16 17

17

Vascular

50

90 48

76

    Access

10

14 8

17

    Anastomosis, Repair, Exposure, or Endarterectomy

10

49 32

46

Endocrine

15

8 21

14

    Thyroid or parathyroid

10

6 15

13

Operative Trauma

10

6 11

4

Non-Operative Trauma

40

38 48

27

    Team Leader Resuscitation

10

8 7

2

Thoracic

20

11 22

30

    Open Thoracotomy

5

1 4

6

Pediatric

20

28 23

31

Plastic

10

13 14

15

Surgical Critical Care*

40

36 42

38

Laparoscopic – Basic

100

132 251

158

Endoscopy

85

157 122

169

    Upper Endoscopy

35

101 68

91

    Colonoscopy

50

54 51

71

Laparoscopic – Complex

75

143 128

112

Total Major Cases

850

658 848

698

    Teaching Asst.

25

8 33

10

 

Simulation and Robotics

Each resident is experienced in simulation at Nuvance Health.

Laparoscopy simulators are available in resident space at Vassar Brothers Medical Center.  The DaVinci Robotic Skills Simulator is available to residents for extra training including off-hour/weekend access so that residents may practice while on-call.  The Robotic Curriculum ensures that each resident develop proficiency in surgical robotics early in residency training.  Once basic and bedside proficiency is gained, residents begin work on our dual-console robotic platform.  Our goal is to assure that each resident is ready for a robotic practice upon graduation.

In addition to robotic and laparoscopic simulation experiences, the Surgical Residency Program at Vassar Brothers has a formal endoscopy curriculum and periodic workshops.  Some recent workshops have included:

  • Vascular anastomosis workshop
  • Skin closure workshop
  • Airway procedures
  • Robotic day
  • Intra-operative fluorescence workshop
  • Surgical Stapling workshop

In addition to simulation options at Vassar Brothers Medical Center, The Harold A. Spratt Center for Simulation and Clinical Learning is a new state-of-the-art facility located at Danbury Hospital.  VBMC residents have access to this center.

Highlights of the Center

The Harold A. Spratt Center produces cutting-edge health care simulation by offering three primary simulation labs replicating an intensive care room; an inpatient general medical surgical room, including a full bathroom; and a labor and delivery/neonatal intensive care room. Each of these labs provides:

  • Flexibility to replicate alternative clinical environments, such as outpatient exam rooms
  • Control rooms isolated from the lab space to allow remote control of simulators and audio/ visual equipment
  • One-way glass to allow learners a sense of independence while maintaining direct supervision by faculty
  • Networking to support the integration of the highest tech simulation equipment available
  • Functioning hospital gas panels with oxygen, air and suction
  • A monitor to display vital signs and data pertinent to a simulation scenario

Features of the Center

The Center also features:

  • A medication room that can be integrated into simulations in the three primary labs
  • A reception area designed and configured to double as a fourth simulation lab
  • High-fidelity manikins that simulate human physiology and pathology
  • Two large debriefing rooms for instruction and discussions
  • Cutting-edge  audio/visual  capability  so scenarios can be recorded and played back for analysis while debriefing and data can be captured for research or assessment
  • A standardized patient program that uses live people trained to act through clinical scenarios
  • Educational and technical support from a specialized simulation team to ensure well-executed and effective utilization of simulation modalities

Teaching

Nuvance Health – Vassar Brothers Medical Center (VBMC) surgical residents have important teaching roles for medical students. We are a primary teaching site for third- and fourth-year students at the Touro College of Medicine, and we routinely welcome visiting medical students to our services.

In addition to teaching medical students, PGY1 residents from the VBMC Transitional Year Residency (Blue, Green) and the Emergency Medicine Residency (Trauma) rotate through the Department of Surgery.

Teaching

Nuvance Health – Vassar Brothers Medical Center (VBMC) surgical residents have important teaching roles for medical students. We are a primary teaching site for third- and fourth-year students at the Touro College of Medicine, and we routinely welcome visiting medical students to our services.

In addition to teaching medical students, PGY1 residents from the VBMC Transitional Year Residency (Blue, Green) and the Emergency Medicine Residency (Trauma) rotate through the Department of Surgery.

How to Apply

How to Apply

We accept all applications through the ERAS only and participate annually in the NRMP Match Program.  Individual requests for personal review outside of ERAS are not considered by the residency program.

Interview Requirements

The following items are required for interview consideration. All items must be received through the ERAS application portal:

  • Personal statement
  • CV
  • Three (3) letters of recommendation
  • USMLE Step 1 or COMLEX-1 pass.
  • USMLE Step 2 or COMPLEX-2 CS score
  • MSPE (Dean’s) letter

 

Interviews
For the 2023/2024 academic year, interviews will be virtual.  Once interviews are released, applicants will have 48 hours to accept or decline the interview date.

H2 Visas are not supported.

Second Look

An optional, on-site second look date will be announced during interviews.  The rank list will be completed prior to the second look date, so the decision to attend will not alter a rank list position.