Program Director Message

Paul WisePaul E. Wise, MDWelcome to our residency training program website. In my role as residency program director, I encourage you to browse the content available on this site to learn more about our program and its offerings. I am often asked by applicants the elements that I consider to be our program’s strengths; a brief summary follows.

First and foremost, we are fortunate to have outstanding faculty and departmental leadership. As chairman, Dr. Timothy Eberlein is very committed to resident education and helps to oversee issues related to resident education and working conditions. He has assembled a faculty that is unmatched in its caliber — each division and section in general surgery has nationally and internationally recognized leaders in their respective fields who are accessible, approachable and outstanding teachers. As residents, our trainees have the opportunity to learn from some of the preeminent surgeons in America. These individuals mentor residents who are themselves training to be the future leaders in American academic surgery.

Second, based on our geographic location and existing programs, we have tremendous breadth and depth in our clinical experiences. Our residents become well-rounded surgeons who are ready for independent practice in any number of areas, although following national trends, the majority of our graduates pursue fellowship training. Our graduates tend to obtain positions in the top fellowship programs or go on to competitive positions in independent practice. 

Our residents are given an option to pursue full-time independent research, most typically for two years between clinical years two and three. We allow flexibility in regard to whether residents pursue this option, how long they stay “in lab” and what they choose to do with this time. A research program director serves as a resource to aid residents in determining which of the many opportunities in our environment fit their interests and long-term career goals. We are fortunate to have the vast resources of Washington University and its research mission accessible to our residents; however, residents are allowed to pursue research at sites remote from St. Louis and/or to pursue non-traditional uses of the “lab time” such as pursuit of degree programs (i.e., MPHS, MBA, MPH). Click here for more information about resident research.

Since 2001, we have held weekly hands-on skills sessions in our Surgical Skills Laboratory. The scope of these sessions ranges from instrument choice and use, basic suturing and stapling techniques, and basic and advanced laparoscopic techniques to sessions covering techniques and procedures using simulated and animal models. Virtual reality training in laparoscopy and endoscopy was added to our Skills Laboratory in early 2004 and includes laparoscopy, colonoscopy and bronchoscopy simulators. Simulator training will play a more dominant role in the resident education experience in the future, as the medical school has recently opened an expansive, multi-disciplinary simulation center.

Our training program is also unique in its participation in the American Board of Surgery’s Early Specialization Program (ESP). This program allows residents to enter specialty fellowship training in either cardiothoracic or vascular surgery one year earlier than usual, while maintaining board eligibility in general surgery. We were the first program in the country to be approved for early specialization in cardiothoracic training. To date, we have enrolled ten residents in the ESP program with excellent results. Cardiothoracic and vascular surgery are the only two specialties currently approved by the American Board of Surgery and Residency Review Committee for early specialization, but we remain poised to offer expanded options, should these be approved by the respective specialties.

We take very seriously the Accreditation Council for Graduate Medical Education mandates with regard to duty hour compliance. We were “ahead of the curve” when we voluntarily adopted duty hour restrictions in advance of the July 2003 restrictions to 80 hours. Our program is in compliance with duty hour limits, and we continue to investigate ways in which we can improve the resident experience. In 2006, the hospital began hiring nurse practitioners to assist with resident inpatient work, allowing increased time for residents to spend in the OR, in clinics and in educational sessions. The department and hospital are committed to duty hour compliance to maximize resident education and well-being.

Nationwide, the attrition rate in general surgery programs is approximately 20 percent per year. We have been relatively spared in this regard, in part, we believe, because of the camaraderie among our residents and the enjoyment residents find from living in St. Louis. The region is full of affordable housing, good schools, great professional sports teams, a world-class symphony, opera, a number of terrific museums and fantastic restaurants. A majority of residents own their own homes, allowing them to build equity in the time they spend in training. Residents enjoy time together not only at work, but also outside the hospital. The department holds season tickets for residents for each of the professional sports teams (Cardinals baseball, Rams football and Blues hockey), giving residents a great diversion from hospital work. Symphony and opera tickets are also frequently made available to residents.

As you may know, applications for positions in general surgery have varied in number over the past several years. Last year, we saw a significant increase in the numbers of applicants to our training program. We feel fortunate to be quite successful in the Match and are enthusiastic about those individuals we have been given the privilege to train. Despite the recent trends with variable applicant numbers year to year, our residents remain of the highest caliber, in terms of both scholastic achievement and humanistic values. I believe we have been able to attract such outstanding individuals because of the strengths our program holds.

I consider our training program to be the premier residency in general surgery today. We are able to provide outstanding clinical exposure to our residents in a stable economic environment, with faculty who are committed to the residents and the institution. The faculty strength, across each discipline in surgery, is unparalleled, not only in clinical activity, but also in research expertise and depth. These strengths, combined with the innovations in duty hours and interactive learning, have resulted in a surgical residency training program that sets the standards for all others. We are proud of what we have to offer and encourage you to browse our website and then come see for yourself the good things that are going on here in St. Louis.