1. Are there any major changes in the program over the next year?
2. What are the program's efforts to improve Wellness and reduce Burnout?
3. How does the program promote Diversity and Inclusion?
4. What is the main strength of this program? How does it differ from other similar programs?
5. And its main weakness?
6. How are the educational conferences structured?
7. What are the number of calls?
8. What are the research opportunities? What about research presentations? Where do residents usually present their work?
9. What about attending national conferences and review courses?
10. What are the Board pass rates of the program?
11. What were the last ACGME citations and what has been done about them?
12. What is the attrition rate of the program?
13. What about Rural Surgery and International rotations?
14. Are there any additional perks not mentioned elsewhere?

1. Are there any major changes planned for the program over the next year?

  • The program is educationally and functionally stable. While there are no transformational changes planned, incremental changes will be made. There have been young faculty added to the teaching staff adding diversity to our staff.
  • On the surgical side, the program has embraced the role of robotic surgery. Residents matching into the program will be expected to obtain basic robotic competency. A robotic simulator has been purchased to help in training of faculty and residents.
    As these broader issues get sorted out it can be expected that the program you finish your surgical training in 2027 will look very different from the program you start your intern year in.

2. What are the program's efforts to improve wellness and reduce burnout?

  • A measure of the programs commitment to Resident Wellness was seen during the COVID pandemic. Our residents provided exemplary care during the COVID pandemic and not one of them missed a day during the pandemic. Duty hours and schedules were modified to limit exposure. Teamwork, adequate PPE, and supportive exposure protocols allowed us to weather the worst of the pandemic without hurting our residents.
  • There has been addition of a PA to the trauma service. Schedules have been modified to ensure a mix of easy and difficult rotations during each academic year. The number of calls has been kept to under 6 per month to reduce fatigue and burnout.
  • The Emergency room call for interns has been reduced to a short call except during summer months. This reduces hours worked for the intern and allows the resident to be on service during daytime hours.
  • The mentoring program has been modified with residents having their choice of mentors. The mentors pro-actively check in on the residents once a quarter and more times if need be. Free counseling is available for at risk residents.
  • Graduate medical education provides each resident $200 a year to decrease cost of gym memberships. This money can be used for other activities such as yoga classes, kick boxing or the cost of a Fitbit. The program has a monthly 10,000 steps a day challenge. The resident that has the most days of 10,000 steps for the month wins an additional $200 in Wellness money.
  • The department generously supports Resident Wellness by sponsoring Resident wellness events. This year we have had a Resident roast, Resident graduation, Welcome party, Clay shooting and a Wine and Paint by Numbers night. Photographs of these events can be found on our Instagram page @sjhsurgery.
  • Residents are provided a jacket with their names embossed on it.
  • The program has been randomized in the Surgical Education Culture Optimization through targeted interventions based on National comparative Data (SECOND) trial run by the ABS, APDS and ACGME. More information can be found here.

3. How does the program promote Diversity and Inclusion?

  • Diversity is central to our core values and our Catholic identity. The program ensures fairness in the recruitment process by using objective criteria for selection to interview for a position. Faculty that interview candidates are counseled on applicable policy and to avoid inherent bias while scoring candidates. The rank list is based on candidate merit with local candidates who will serve our local communities getting a tie-breaking vote among equals.
  • Each resident is matched with an appropriate mentor to ensure wellbeing, retention, and successful completion of the program.
  • Two faculty members from communities under-represented in medicine have been added to the Clinical Competency Committee. They will be involved in the selection process of next year's class. The program has made efforts to mentor medical students from underrepresented in medicine communities.
  • We currently have over 50% women in our surgical program.

4. What is the main strength of this program? How does it differ from other programs?

  • It is not fair and impossible to make direct comparisons between similar programs. We believe we have a collegial learning environment and abundant clinical material.
  • Our board pass rates are consistently above the national average and reviews of our graduating resident surgical acumen have been good. Graduating residents going on to do General Surgery have felt comfortable in independent surgical practice.
  • There is good formal and informal mentorship as shown by our academic output and placement of residents in competitive fellowships.
  • The program takes considerable pride in many of our residents who practice independently in rural areas on graduation

5. And its main weakness?

  • Opportunity to do bench research is limited. The program does NOT have an opportunity to take a year off to do research. Our focus is on training clinically strong operating surgeons in 5 years. We have not placed a resident into Pediatric Surgery due to this limitation.
  • There is no dedicated Endocrine surgery rotation. Endocrine surgery experience is gained from general surgeons experienced in endocrine surgery.
  • Our oral board pass rates should match our written board pass rate of 100%. Steps have been taken to increase the number of mock orals and training of residents in mock oral board techniques.
  • There are no International rotations and no current plans to develop one.


6. How are educational conferences structured?

  • The program has 5 hours of protected time per week for educational conferences. Residents are free of all clinical responsibility except the care of life-threatening emergencies.
  • The conferences begin on Monday from 7.00 – 8.00 AM. This time is used traditionally for ABSITE and board review and administrative discussions.
  • Thursdays are our main conference day. The conferences run from 7.00 AM to 9.00 AM and include SCORE topics, basic science lecture series, grand rounds, trauma conference, tumor board, journal clubs, and a weekly M and M conference.
  • On Tuesdays, interns have simulation early in the year and ABSITE review classes from September to January. Second years are instructed in FLS skills from February to June.
  • Residents are exposed to 2 mock oral exams in the year and ABSITE review sessions are held frequently from November to January.


7. What are the number of calls?

  • Call averages once every 5 nights and it is in-house. We do not have a night float and call tends to be busy. Our ER sees over 115,000 visits a year and the staff and trauma services are busy.
  • PGY-5 residents take 6 calls from home. They come in for operative cases and for Level 1 Trauma activations. 


 8. What are the research opportunities? What about research presentations? Where do residents usually present their work?

  • Research activity is particularly robust for an independent academic center with regular presentations at Detroit Surgical, Midwest Surgical Association, Michigan Chapter, and the American College of Surgeons Clinical Congress. A proxy for the research activity is the fellowships that our residents have garnered over the years.
  • Research opportunities are primarily clinical outcomes research. Research is done concurrent to the clinical program. Each resident is required to complete a research project prior to graduation. Many residents complete more than one project.
  • There are clinical databases in Surgical Oncology, Breast, and Bariatric surgery to help in your research. There are also statisticians and post-doctoral fellows available to help formulate your project. Dr. Richard Haywood is our in-house PhD to help with your projects.
  • A full list of our research activity can be found under the research tab on this website.


9. What about attending national conferences and Review courses?

  • All residents have the option of attending the Detroit Trauma Symposium. PGY-3 to PGY-5 residents have additional funding to attend a national conference or review course.
  • Senior residents traditionally have used these funds to attend the American College of Surgeons Clinical Congress or national level meetings in the allied surgical specialties.
  • Residents presenting their research will have their expenses covered by the department.


10. What are the Board pass rates of the program?

  • The ACGME and ABS have gone to independently reporting 3-year first time oral and written exam pass rates. The last reported rates on the ABS website is for the 2018-20 reporting period and reported in September 2020. The 3-year first time written exam pass rate is 100% and 62% for the oral exam. COVID has skewed the data as to when graduated residents first took the exams.


11. What were the last ACGME citations and what has been done about them?

  • The program has 2 citations and that are aggressively addressed. The program views these citations as opportunities for improvement.
    • Citation 1: Ability to raise issues without fear of intimidation: There is greater emphasis on meeting with resident mentors and class mentors. Mentors reach out to each resident to proactively seek problems that need solutions. Surveys of residents show that elements leading to this citation have significantly improved over the past few months.
    • Citation 2: Feedback can be improved in the program: Following the citation, attending surgeons have proactively reached out to the residents at the end of the procedure to provide individualized and focused feedback. Residents meet with a faculty member at the end of the rotation to get individual feedback.  
    • It is expected that conditions have changed sufficiently to have these citations withdrawn. The program is due for its 10 year self-study and ACGME review but that has been delayed due to COVID.


12. What is the attrition rate of the program?

  • The 5-year attrition rate is 6% for residents who directly matched into the program. Recently, attrition has been due to change of career plans or not being a fit for this program. As you may have guessed by now, surgery is not for everyone.
  • The program makes every effort to aid at risk residents to complete the program or find alternate careers suited to the residents’ abilities and interests.


13. What about Rural Surgery and International rotations?

  • The program created a PGY-3 rural surgery elective in Traverse City. This elective has had rave reviews and residents who have been there have developed rapidly on their course to be independent operating surgeons.
  • A PGY-4 elective in Marquette, MI is also being considered. These rural surgery rotations allow for residents to concentrate on bread and butter general surgery in high volume rural hospitals.
  • There are currently NO options for international rotations. We are constantly re-evaluating this issue from multiple angles – educational rationale, service vs. education, resident safety, supervision, and costs. This may become an option in a few years, but this is not an option at present.


14. Are there any additional perks not mentioned elsewhere?

  • The program is well funded and departmental support for resident education is at an all-time high. Residents automatically become members of the American College of Surgeons and the Detroit Surgical Association. Residents are invited to attend all dinner meetings of the Detroit Surgical Association and the Academy of Surgery.
  • Latest edition books, SESAP during your PGY-3-year, surgical loupes as a PGY-2, meal card ($1500), and free parking are some of the additional perks not mentioned elsewhere.
  • Any research project accepted for presentation at a regional meeting is fully paid for along with time off that does not count towards vacation time. There are professional development funds that vary between $600-2200 per year.
  • Since last year, the program has paid for USMLE registration fees.
  • Registration fees for the Qualifying exam of the American Board of Surgery is paid by the department for all graduates.
  • Nespresso Machine!
  • These perks compliment the strong academic and clinical program at St. John.