PGY-1
The integrated PGY-1 year encompasses time in Surgery and Urology. There are 13 4-week rotations incorporating 7 rotations of general surgery (including Acute Care Surgery, Colorectal Surgery, Surgical Oncology, Surgical ICU, and Pediatric Surgery) and 6 rotations of urology (including 1 block of VA Urology). This schedule is coordinated with the general surgery program to ensure an adequate base of the care of surgical patients can be obtained.
Listed below is a general overview of each year. The skills, objectives and responsibilities of each year of the residency are published in Med-Hub and distributed at the beginning of the year and prior to each rotation.
Second year
Second-year residents rotate through both adult and pediatric urology at Dartmouth Hitchcock Medical Center. Continuity of care occurs by seeing new patients in clinic, operating on and caring for the same patient post-op, and then seeing patients return to clinic for follow-up. Every 3 months they rotate to another team. While assigned to a particular team, residents attend clinic and operate with the team's attendings.
During the pediatric urology block, the resident spends a half-day per week going to transplant clinic, where they are involved in the workup of new patients and the follow-up of patients on whom they have operated. They participate in donor nephrectomy and in transplantation.
Third year
Third-year residents rotate through adult urology service at Dartmouth Hitchcock Medical Center for 3 months, rotate at the VA for 3 months of VA clinical urology and mentored research, and have two 3-month rotations as the junior resident at Concord.
During the 3-month rotation at the VA, residents participate in the inpatient and outpatient urology service to gain additional expertise in the model of care at a VA medical center, and have 50% protected time for mentored research.
The Concord Urology rotation provides a high surgical volume with exposure to both general and subspecialty urologic care in a community setting.
Fourth year
Fourth-year residents return as senior residents at Concord Urology. At Dartmouth Hitchcock Medical Center, the fourth year senior resident is additionally responsible for managing the consult service. The resident has increased responsibility assigned to them each time they rotate on each service.
While assigned to a particular team, residents attend clinic and operate with the attendings. The DH Senior Resident Clinic allows a tremendous opportunity to provide continuity of care, seeing new patients with attending back-up, planning and performing surgical care, and caring for and following their patients in postoperative follow up.
Fifth year: Chief Resident
Fifth-year residents rotate at Dartmouth Hitchcock Medical Center for 12 months, with 6 months as the administrative chief resident. Attending’s give the chief resident increased responsibility in caring for patients. The administrative chief resident is responsible for the entire service. Although residents may be assigned to teams during certain rotations, the chief resident will oversee the assignment of cases to ensure that cases are assigned to an appropriate-level resident while still allowing junior residents to participate in complex cases.
The resident is ideally the operating surgeon under supervision on the most complex cases. Continuity of care occurs by seeing new patients in clinic, operating on patients and caring for them post-op, and then seeing patients return to clinic for follow-up.