Why did you want to come to Ascension St. John?

  • It seemed to have the best blend of an academic program (research opportunities, good fellowship match, complex cases) and a community program (comradery, case volume, autonomy in OR, and only 1 fellow).

~ John Kanitra, PGY-4

  • During my interview day, I was struck by how happy the residents were here. There seemed to be a great work/life balance, while still providing excellent technical training. I got the impression that training at St. John gave residents the tools to pursue competitive fellowships in a variety of specialties, but that residents did not necessarily have to complete a fellowship because they lacked operative and clinical skills. I appreciated the flexibility to be open to subspecialty training or to be equipped to go right into general practice after 5 years here.

~ Victoria Simmons, PGY-5

  • Ascension St. John hospital offered several aspects that appealed to me. The hospital is neighboring both Grosse Pointe and Detroit, offering the experience of being able to treat a unique patient demographic. When I met the surgical residents here, they were very satisfied with their education and the amount of autonomy they had in the operating room ranging from basic surgical procedures to more complex operations. The community hospital setting also offered a welcoming learning environment. 

~ Tatiana Fedorova, PGY-5

  • The people. I had the privilege of rotating at Ascension St. John as a medical student and even then, I recognized that this program had an inclusive culture that celebrated resident successes whilst working with residents to overcome their weaknesses. This program truly fosters collegiality and professionalism between residents and faculty.

~ Isabella Graham PGY-1

  • St. John really stood out to me compared to other residency programs, mainly because the program has everything you need for surgery residency in one place and has a great culture for learning. The relationships with the attendings allow for education without feeling malignant. It was my top choice and I know it was a top choice for most of my co-residents as well. 

~ Lindsey Rinker,  PGY-2

  •  After my interview day, I felt like St. John would be the best fit for me. It was a combination of the people, including both residents and faculty, along with the opportunities for exposure to broad based general surgery in a busy urban setting that stood out most to me.

~ Nicholas Rauh, PGY-3

  • I was fortunate enough to rotate through all the Detroit area surgery programs as a medical student. St. John stood out for a number of reasons, but most notably for the comradery between the residents and the autonomy in the operating room. 

~ David Clausen, PGY-2

What’s your favorite service or favorite case?

  • My favorite service is service 1. This is our true "bread and butter" general surgery service. You see a wide variety of pathology and it is a high operative volume as well. The attendings on the service are wonderful to work with and really give you a lot of autonomy. My favorite case is a trauma exploratory laparotomy because you never know what you're going to find, and you must be prepared to deal with whatever the injury is.

~ Sejul Chaudhary, PGY-5

  • My favorite service is Service 1 -- it is a combination of colorectal surgery and general surgery. There are a lot of great general surgery cases, both minimally invasive and open, as well as complex and cutting-edge robotic surgeries for colorectal problems. Even as a junior resident I was able to get a surprising amount of robotic surgery experience on this service.  

~ Lindsey Rinker, PGY-2

  • I enjoy working on the Vascular Surgery service for the variety of open and endovascular operations as well as bedside procedures. It is a busy service that offers early opportunities to develop technical skills including central venous access for hemodialysis, endovascular procedures, and open surgical exposure of peripheral vascular anatomy.

~ Nicholas Rauh, PGY-3

What do you wish you knew before starting residency?

  • Much of what is most important in being an intern/resident comes from what is learned on the job. Studying and reading are of obvious importance, but the skills and general knowledge that is built during the first few months of residency is invaluable. There is a steep learning curve but being a part of a busy residency program with opportunities for early autonomy fosters confidence in both medical and surgical skills/knowledge.

~ Nicholas Rauh, PGY-3

  • I wish I would've known how lost I'd feel starting residency. Luckily at St. John, the residents and staff are amazing and made the transition much easier and quicker than I thought it would be.

~ Trevor Braeger, PGY-2

  • No amount of studying could prepare you for residency. The most important lessons will be learned on the job and in the moment. You are going to struggle sometimes, but at St. John there are lots of people that are willing to help you. As a first-year resident, I feel very supported by the other residents and I would feel comfortable asking any of them for help if I needed it.

Katie Parks, PGY-1

  • While everyone tells you that the intern year is difficult, it’s hard to imagine the reality until you get here. From navigating a new hospital system and EMR to learning whole patient management, there are so many new things to master. Luckily, we have understanding seniors and attendings who catch us up to speed and provide excellent learning opportunities. I feel comfortable coming to any of my co-residents with any issue at all and feel incredibly supported in this environment.

~ Medea Shanidze, PGY-1

What’s unique about this program?

  • I knew that I wanted to find a program that would teach me valuable technical and clinical skills right from the beginning. There is still a lot of floor work as a junior resident, but interns and second year residents are also covering cases on their own with the attending surgeon starting July 1st. The ACGME requires 250 cases by the end of 2nd year, which most of us had that number by the beginning of 2nd year, if not by the end of intern year. We also don't have fellows, so we can participate in major surgical oncology, vascular, and pediatric surgery cases. The program buys loupes for us our intern year, which is a huge bonus. We can use our educational money to travel to conferences, and our residents travel to different professional association meetings (Michigan ACS, Midwest Surgical, national ACS conference) throughout the year.

~ Victoria Simmons, PGY-5

  • The work-life balance. From the top down, this program recognizes the importance of resident wellness. Residents have every opportunity to develop their clinical and technical skill set while still having a life outside of the hospital. This was a very influential factor for me as I travel often to see family and have a dog and fiancé to go home to every night. 

Isabella GrahamPGY-1

                                               

  • We function as a team and are not malignant. People are here to help you, not hurt you. We get a hands-on experience starting day one.

~ Meryl Ethridge, PGY-4

  • Early operative experience and working one on one with attendings as a first year. Multiple opportunities to have a life outside of work and medicine. The work life balance that this residency provides is one of a kind and one of the multiple reasons why St. John was my top choice.

Katie Parks, PGY-1

What is the case volume like? 

  • High operative volume with chief residents obtaining all required cases during or before fall of PGY-5 year. First year residents scrub several minor cases and double scrub larger cases with more senior residents for early and abundant OR experience.

~ Nicholas Rauh, PGY-3

  • The case volume is never something this program has struggled with. Most residents reach their required case volumes as a chief by the middle to end of their fourth year.  Your confidence handling surgical cases will be high coming out of this program and you will be able to operate independently without need for fellowship training. 

John Holtrop, PGY-4

What’s day to day life like?

  • The interns arrive around 5:45 to get sign out. The patient list is made, and patients are divided up between the junior residents. We then pre-round and meet the chief resident around 7 to run the list. We discuss patients and put in any pertinent orders. Cases start between 7-7:30, so the morning is usually busy, and cases continue throughout the day. We check on patients, see consults, do bedside procedures and round with attendings in between cases. Sign out to the night call team starts at 4:30, with a hard rule that everyone who isn't on call is out by 5pm.

~ Sejul Chaudhary, PGY-5

  • Most days are consistent with morning individual rounds followed by running the list with the rest of your team. OR assignments are discussed the day prior and cases are covered accordingly. Group rounds with an attending are typically made later in the morning. Lectures are held throughout the week with dedicated time on Thursday mornings for SCORE, Grand Rounds, M&M, and other topics. Weekly clinic assignments vary between services.

~ Nicholas Rauh, PGY-3

How does the call schedule work?

  • We take 24 hr calls as interns, up to 7 times per month. Typically, interns have between 4-6 calls a month. We do not have night float teams however; you are on call with other senior residents and fellow interns so there is always a team to back you up if needed. Plus, as an intern and up until chief year, you have post-call days after completing a call shift- which means you leave the hospital by 10am the following day. 

~ Isabella Graham, PGY-1

  • Typically, 6 call shifts per month. A total of 4 days off are provided each month, assigned as two full weekends free from both rounding and call responsibilities. Generally speaking, interns take floor or ER-1 call (float between ER and OR as needed for additional coverage), PGY-2 are assigned to ER consults, PGY-3 are assigned to ICU call, PGY-4 are assigned to in-house senior call covering OR cases and staffing consults from floor and ER, and PGY-5 are on home call with coverage of surgical emergencies including level 1 trauma activations.

~ Nicholas Rauh, PGY-3

What type of research have you participated in?

  • There are plenty of research opportunities for those who are interested. There are databases for Trauma, breast and surgical oncology and the attending faculty like to publish, which facilitates resident involvement in research in those fields. Additionally, the department of surgery has a dedicated PhD researcher to assist residents with projects. Because of our high volume, research in other fields is feasible but is largely resident driven. I have an interest in vascular surgery, which does not have a database  and have been able to publish/present multiple projects in vascular.

~ John Kanitra, PGY-4

  • I completed the minimum amount to fulfill my graduation requirements. Everyone is required to finish one research project prior to graduation.  The manuscript does not have to be published; however, the majority of the resident's projects are published and are presented at local and national conferences. 

~ Mark Sarazin, PGY-5

What is education/conference like?

  • Didactics are well organized to include a variety of topics ranging from basic science, to hands-on vascular labs, M&M’s, near miss, guest speakers, SCORE topics, mock orals and much more. Every Monday 7-8am we have group lecture varying from guest speakers, basic science lectures, and residency housekeeping tasks. Thursday morning 7-10am we have protected lecture time. This includes an hour of small group discussion based around SCORE topics, an hour that varies in subject, and concluded with our Morbidity and Mortality conference. Additionally, as interns, one hour each Tuesday is dedicated to lecture revolving around intern specific topics. At the beginning of the year this included basics like navigating the EMR, to suture practice, and progresses to include more basic science, as well as practicing different procedures. Overall I feel our lecture experience includes a robust variety of topics that hones our abilities as surgeons. 

~ Tyler Masters, PGY-2

What’s the biggest weakness of the program? Is there a specialty you wish you had more exposure to?

  • There is not an opportunity to take time off during residency to do additional training such as MBA, MPH or outside hospital research. We do not have as much exposure to transplant (liver, pancreas, small bowel), and endocrine surgery.

~ Tatiana Fedorova, PGY-5

  • One of the great things about the program is the response our leadership has had to our previous answer, which was that we did not get enough exposure to thoracic surgery. We have since hired a thoracic surgeon that works exclusively with residents and the thoracic experience is now tremendously improved as a resident as far as involvement. We now have thoracic patients that we follow and manage in the hospital on the floor and in the ICU, which we did not do previously.  The experience will continue to improve as this attending adds more complex cases, such as esophagectomies. 

~ Lindsey Rinker PGY-2

What perks come with residency at St John?

  • There are several perks within our program including $1500 meal stipend as well as free buffet lunch Monday-Friday, free parking in a covered garage, wellness money for health/fitness expenses, educational money for board review material/textbooks, incentives for attending local and national conferences. Vacation requests are consistently honored, with 3 total weeks of vacation time granted per year with an additional 4-5 day block off during either Christmas or New Year’s.

~ Nicholas Rauh, PGY-3

  • Our days off are always 2 full weekends (Saturday and Sunday) a month. I feel like this makes it easier to get things done on the weekend or see one another outside of work.  Even if someone is rounding on a weekend morning, they are free the rest of the day. One thing I did not consider before starting is that sometimes there will be a 3, 4, or 5 week stretch between weekends off. I still prefer having weekends off to random days off during the week throughout the month, but it is something to keep in mind.

~ Victoria Simmons, PGY-5

  • We are absolutely spoiled by our program, as one of my favorite perks is the new, fully stocked Nespresso with a milk frother. We now have 24/7 latte-making capabilities that definitely helps keep us fueled for the 24 hour calls!

~ Lindsey Rinker PGY-2

What do you like to do outside of the hospital?

  • The thing that I like to do the most outside of the hospital is golf. We’re lucky enough to have a program director who is also an avid golfer and generous enough to take us to his club. There are also other well kept courses located locally, and even more top tier ones located further north. 

David Clausen, PGY-2

  • I like to run and play soccer including pick-up soccer games with other SJH programs mainly IM residents, EM residents, and Cards fellows. I also frequently go with my classmates to enjoy the numerous restaurants and breweries throughout Detroit and nothing beats a good post-call brunch. 

~ Tyler Williams, PGY-5

  • I go to the climbing gym often (which you can use your wellness fund to pay for).

~ Mark Sarazin, PGY-5

  • There is so much to do outside of the hospital! We get 3 weeks of vacation a year, with the option to break up one of those weeks into individual days or blocks of days. Vacation scheduling is very flexible for the most part, if it is requested early. My class loves getting together for dinner or drinks! We have gone apple picking for the past 3 years. We get together in the summer and fall for bonfires. Michigan has so much to offer, with fun events and new restaurants to check out in downtown Detroit, kayaking or boating on the Detroit River or Lake St. Clair, and hiking up north. The residency program also organizes events throughout the year, including Top Golf, Whirleyball, and get-togethers like the annual Christmas party.

~ Victoria Simmons, PGY-5    

What is the program's response to its ACGME citations?

  • The program citations were a shock to all of us, but the leadership have taken action to show that we are willing to do whatever it takes to improve the program. I think this experience can be turned into a positive aspect -- when there are issues raised, the program leadership takes great responsibility in resolving them so that the residents feel like they are being heard.

~ Lindsey Rinker PGY-2

What does the program do to prepare you for the board exam?

  • The program does not do anything novel for board prep; weekly SCORE questions, weekly lectures that focus on SCORE, and additional mentoring/teaching for residents struggling with ABSITE scores, likely similar to most programs since most residents have no problem passing the written boards. We have room for improvement on our oral board pass rates, so the program has shifted to focus on oral exams by having 2 practice oral board sessions per year and adding small group lectures that focus on oral boards. I think one of the largest advantages of the program is our strict adherence to duty hours, which helps limit burnout and facilitates time for residents to study.

~ John Kanitra PGY-4

What is your interaction with your mentor?

  • I meet with my mentor several times a year and feel like I can go to him with any clinical or professional concerns that I might have. I feel very supported by my mentor. An additional thing we added was class mentors; the PGY-2 class has been doing fun activities outside of work for our mentor meetings, such as going bowling and having a pizza party. It was great to be able to discuss any program concerns in an informal environment.

~ Lindsey Rinker PGY-2