Surgery Residency

I.    Objectives of the Surgery Residency Program

Surgery residents hold appointments as Veterinary Clinical Associates or Veterinary Resident Instructors. Residents are funded by Texas A&M University and are expected to provide patient care and teaching assistance in the clinical programs of the College of Veterinary Medicine and Biomedical Sciences. The clinical service assignments and educational programs are established to meet, and in most cases exceed, the minimum requirements for residency training programs as outlined by the American College of Veterinary Surgeons (ACVS). Faculty will make extensive efforts to provide an outstanding program, but the ultimate responsibility for value gained from the program lies with the resident. 

The training objectives of the surgery residency program are as follows: 

      A.  Promote aptitude and clinical proficiency in the diagnosis, operative treatment, and postoperative management of animals with surgical disease(s) 

      B.  Instruct the resident in the science and practice of veterinary surgery and its supporting disciplines.

      C.  Provide the resident with the opportunity to pursue career goals in teaching, research, clinical service, or specialty practice. 

      D.  Permit and allow the resident to satisfy the requirements for board certification set forth by the ACVS. The resident should check the ACVS website (www.acvs.org) and review residency requirements within the first month of residency. It is the resident's responsibility to be familiar with the most current ACVS requirements; and to ensure they meet those requirements and submit all required forms during the 3-year program.

      E.   Prepare the resident to express clinical ideas and concepts to other members of the veterinary profession in a concise, professional manner (e.g., seminars, lectures, conferences, laboratories, and publications). 

      F.   Prepare the resident to qualify for examination and certification by the ACVS.

II. Graduate Degree Program     

      A. Concurrent Master's or PhD degree programs are currently not available. Residents wishing to pursue a PhD program may investigate the available options to apply for programs consecutively (e.g. PhD followed by a residency or vice versa). 

III. Surgery Residency Program

      A. Program Overview

            1.   Clinic service. At least 94 weeks of the 156-week program will be spent on a surgical service (orthopedic, soft tissue, or neurologic) under the direction of an ACVS diplomate. This will include in-depth training related to patient evaluation, diagnostic procedures, therapeutic techniques, instrumentation, and overall surgical management of a variety of surgical diseases. Experience will also be gained in understanding fee structures and developing client and referring veterinarian relationships.  

            2.   Emergency duty. The resident will perform emergency surgery and manage emergency surgical cases.

            3.   Off-clinic time. At least 31 weeks of the program will be assigned as off-clinic time. This time should be scheduled with the approval of the Resident Advisor, and may be used for any of the following Special Rotations: 

                  a.   research or clinical investigation

                  b.   preparation of scientific manuscripts 

                  c.   national or international level continuing education courses

                  d.   special veterinary rotation 

                  e.   special external rotation at a human hospital or with a medical program in the College of Medicine is encouraged

                  f.    vacation time may be taken for no more than 6 weeks of the 156 week program 

                  g.   At least 8 weeks of the program will be spent studying disciplines associated with surgery. The resident will obtain at least 80 hours (preferably in one 2-week period) of training under the supervision of a diplomate of each of the specialty boards listed below.

                        i.    American College of Veterinary Anesthesiologists,

                        ii.   American College of Veterinary Internal Medicine or American College of Veterinary Emergency and Critical Care,

                        iii.  American College of Veterinary Pathology,

                        iv.  American College of Veterinary Radiology.

            4.   Rounds participation. Residents are required to attend daily surgery service rounds and weekly resident rounds (case rounds, topic rounds, journal club). The resident must regularly present cases at surgery resident case rounds, which are held weekly or biweekly. Participation in human medical conferences is encouraged. In addition, attending rounds and seminars held by other veterinary specialties within the college (e.g., radiology, necropsy, pathology, clinical pathology, physiology, etc.) is encouraged.

            5.   Research and publication. Participation in basic or clinical research will enhance the resident's understanding of the scientific method and contribute to the literature. Interdisciplinary research and association with the College of Medicine is encouraged. The resident will complete a research project or clinical investigation, which will result in a first-author publication that follows a scientific approach. The manuscript should be submitted to a publication on the ACVS Approved Journals List.  The manuscript must be fully accepted for publication prior to August 1 in the year that credentials are submitted to ACVS.

            6.   Seminars. Presentation of six distinctly different seminars during the program is required by ACVS. The goals of this are to provide the resident with exposure to a broad variety of surgically related subjects, and to give the resident experience giving a formal scientific presentation followed by a discussion period in a public forum. They should be in-depth presentations given to peer audiences. Seminars may not include multiple presentations of the same topic or lecture.               

Attendance and participation in the departmental Faculty-Intern-Resident Seminar Program is required. The Head Resident and Faculty Coordinator for this program will schedule and assign responsibility for activities within this program. Participation in this program will enable the resident to present at least 3 of the 6 seminars required by ACVS.

            7.   Clinical teaching. The resident is required to participate in the clinical education of graduate veterinarians and veterinary medical students assigned to the surgical service rotations. 

            8.   Didactic teaching. Participation in didactic and laboratory instruction of students in the professional curriculum is another component of residency training. The resident may be required or elect to help with laboratories in certain courses. This affords teaching experience as well as further professional development.

            9.   Resident evaluation. The resident's progress and formal evaluation will be assessed by meeting with the Resident Advisor at least twice yearly throughout the 3-year program. This is typically done together with the Surgery Residency Committee. Continuation of the residency is contingent on the resident's satisfactory evaluation by the Surgery Residency Committee.           

      B.   Appointment

The academic rank of the resident will be Veterinary Resident Instructor. 

      C.   Salaries and Benefits

            1.   Salaries are determined annually by the Head of the Department. They are standard for all residents in the Department of Veterinary Small Animal Clinical Sciences (VSCS), and salaries currently increase with each year of service.

            2.   Residents may participate in the University's medical-surgical health insurance program.

            3.   All courtesies, such as athletic ticket purchases, use of university facilities, etc., are the same as for other faculty.

      D.   Certification of Completion of Program

A certificate of completion of the residency program will be presented to the resident upon successful completion of the 3-year surgery residency. A certificate will not be given for partial completion of a 3-year program or if the resident project is incomplete or unsatisfactory.

      E.   Duties and Responsibilities

            1.   Clinical service 

                  a.   Responsibilities on surgical services include:

                        i.    receive clinic appointments 

                        ii.   supervise daily management of hospitalized animals. Animals are assigned or transferred to the most appropriate hospital service, based on the nature of their primary problem.

                        iii.   attend surgery service rounds   

                        iv.   participate in phone consultations with veterinarians and clients.
The degree of responsibility will depend upon the nature of the surgical problem and the resident's level of training and skill. 

                  b.   The senior surgical resident may be placed in charge of a clinical student group for selected weeks during his/her 3rd year of the program, allowing demonstration of the resident's surgical and organizational expertise and leadership. An ACVS diplomate will be assigned as a supervisor during each block of clinical service as "chief" resident.

                  c.   Holiday duty assignments will be determined by the Chief of Surgery and the Head Resident. 

                  d.   After the yearly clinic schedule has been established, if the resident desires a schedule change he/she must obtain consent from the senior clinician(s) of the clinical service(s) affected by the proposed changed. If the schedule change involves off-clinic time, the Resident Advisor must be consulted. An email with the requested change should be sent to all senior clinicians involved. If all involved senior clinicians give consent to the change, a written request (e.g. email) may be submitted to the Section Chief in charge of scheduling.

            2.   Emergency duty

                  a.   Residents are required to participate in the emergency services provided by the Small Animal Clinic. The emergency surgery duty schedule will be assigned by the Head Resident using a rotating schedule. Although every effort will be made to make emergency duty assignments as fair as possible, variations in assignments may be necessary to facilitate the function of the Veterinary Teaching Hospital.               

                  b.   Emergency duty responsibilities include:

                        i.    Provide backup support to interns on emergency cases.

                        ii.   Accept and manage emergency surgical cases as transfers.

                        iii.  Take case transfers on weekends to facilitate patient care of surgery referrals. Consider consulting with surgeon who will be taking the case the following Monday with any questions on case management.

                        iv.  Perform after-hours emergency surgical procedures. Soft tissue and orthopedic emergencies are transferred to the appropriate service on the next business day.

                        v.   Examine potential surgical emergencies and discuss with the faculty back-up surgeon. The faculty back-up surgeon must be consulted prior to anesthetizing any emergency surgery case. The back-up surgeon will come in to assess the animal and assist with every surgery during the first 6 months of the residency. For the remaining 30 months of the resident's program, the surgeon will come in to assist if either the resident or the surgeon prefers it.

            3.   Off-clinic time

                  a.   For a number of weeks every year, residents will be not be assigned to a clinical surgery service. This off-clinic time is to be used to complete various requirements of the residency program. The resident and his/her Resident Advisor should plan how to best use this time each year.

                  b.   Scheduling of the off-clinic time should be coordinated by the resident, Resident Advisor, and the Section Chief of Surgery.

                  c.   Typically, 8 weeks are scheduled off-clinics in Year I, 12 weeks in Year II, and 8 weeks in Year III. The final 8 weeks of the residency program may not be taken as off-clinic time without approval of the Surgery Residency Committee.

                  d.   If a special out-rotation is planned (besides the required anesthesia, medicine, pathology, and radiology), the resident should provide a written statement of goals for the Resident Advisor and Program Director. Once approved, the travel information should be submitted online through eTravel/Concur at https://sso.tamus.edu. Upon completion of the special rotation, the resident may be asked to share new knowledge during resident rounds.

                  e.   An out-rotation in a human hospital or specialty veterinary referral practice may be considered for 1 to 4 weeks during off-clinic time in the 3^rd year.

                  f.   If a surgical out-rotation is done in veterinary practice, ACVS External Surgical Rotation form must be submitted to the ACVS with the Credentials Application.

                  g.   When vacation time is desired, the resident must discuss this with his/her Resident Advisor and submit an official vacation request online through LeaveTraq at https://sso.tamus.edu 

            4.   Rounds and conferences

                  a.   Required participation in conferences within the College of Veterinary Medicine & Biomedical Sciences. Attendance is required unless time away is documented by LeaveTraq (vacation leave) or eTravel/Concur (leave for professional meeting or out-rotation) by filling out required information at https://sso.tamus.edu

                        i.   Daily rounds on assigned clinical service is required. The degree of participation will vary with the service and will be determined by the senior clinician.

                        ii.   Weekly or biweekly surgery resident topic rounds

                        iii.  Weekly or biweekly surgery resident case rounds               

                        iv.  Weekly or biweekly surgery journal club

                        v.   Monthly morbidity and mortality case rounds

                  b.   Conferences for which participation is recommended:              

                        i.    Radiology or MRI rounds          

                        ii.   Anesthesiology rounds

                        iii.   Surgical pathology rounds                       

                        iv.   Various conferences within the College of Medicine

            5.   Research and Publications

                  a.   The resident will complete a basic research project or clinical investigation.

                  b.   If funding is required, the resident is expected to seek outside funding for the research project with guidance provided by the Resident Advisor or the faculty member supervising the project.

                  c.   The resident will be the primary author on the research manuscript. It is strongly advised that this paper be reviewed by the resident's advisor or research mentor by February 1^st of the 3rd year in order to submit the manuscript for publication by the end of the residency.

                   d.   The resident is required to satisfactorily present the completed research in a departmental or surgery section seminar by June 1^st of the 3rd year.

            6.   Seminars

                  a.   The seminar program consists of a variety of scheduled professional development activities (clinicopathologic conferences, seminars and group discussions) arranged by the Head Resident in conjunction with a Faculty Coordinator. Seminars are presented on a rotating schedule.

                  b.   At least 3 of the 6 seminars required by ACVS will be presented in the departmental Intern-Resident Seminar Series. Attendance and participation in the departmental faculty-intern-resident training seminar series is required.

                  c.   Residents should consult with their Resident Advisor for opportunities to present the seminars required by ACVS. Some possibilities may include intern rounds or hospital continuing education meetings. Lectures to students will only fulfill the seminar requirement if they are supervised, attended and critiqued by faculty.        

            7.   Teaching Responsibilities

                  a.   The resident is required to participate in clinical teaching of surgery and patient management in the professional student program. The resident is expected to participate in daily student rounds and to help in the clinical instruction of third and fourth year veterinary students.

                  b.   The resident will be expected to assist in didactic and laboratory instruction of students in the professional curriculum. Residents shall not have major teaching responsibilities for any course.

                  c.   The resident will be assigned to assist in the teaching of Surgery I (VMID 935), Surgery II (VMID 936) and the surgical portion of General Surgery/Anesthesiology (VMID 923), and will be responsible for selected lectures in courses in the professional curriculum.

            8.   Documentation

                  a.   The resident is responsible for understanding the requirements of their program and completing all required forms, based on the ACVS Residency Program Guidelines for the year in which the residency begins. This document can be found in the Residents section of the ACVS web site (www.acvs.org).

                  b.   The surgery resident must track surgical procedures performed, using the Cases section of the Resident Training Log on the ACVS web site. This log must be reviewed and signed by the resident advisor semi-annually by February 1^st and August 1^st of each year. A minimum of 400 major surgical procedures is required over the course of the residency. Details of the required Core Curriculum may be found in the ACVS Residency Program Guidelines.

                  c.   The resident must document the progress of the program through use of the web-based Resident Training Log. The Resident Advisor will approve log items and complete a Semi-Annual Performance Review online. The ACVS Resident Credentialing Committee will evaluate the log semi-annually (February 1^st and August 1^st).     

                  d.   Any vacation time must be requested by submitting an online request  through LeaveTraq at the TAMU Single Sign On web site https://sso.tamus.edu

                  e.   Out-rotations or travel to continuing education meetings must be documented by an online request (eTravel/Concur) at the TAMU Single Sign On web site https://sso.tamus.edu.

      F.   Overview of Resident Responsibilities - Year by Year

            1.   First Year Surgery Resident

                  a.   The resident must submit Statement of Compliance (ACVS form 1c) to the ACVS office within 30 days of the start of the program.

                  b.   The resident should receive a completed copy of the "Program Director's Statement" (ACVS form 1a) from the Program Director within 30 days of the start of the program, and the resident should keep this form on file for the Credentials Application. The resident will not have access to Resident Training Log until the Program Director has submitted this form to the ACVS along with a matriculation fee.

                  c.   The resident must be assigned a Resident Advisor within the first three months. The resident should receive a completed copy of the "Registration of Resident Advisor" (ACVS form 1b) from the Resident Advisor within the first 3 months of the start of the program, and the resident should keep this form on file for future submission with the Credentials Application.

                  d.   The Resident Advisor and resident should meet early in the year to plan his/her individual 3-year residency program and ensure all ACVS requirements will be met. 

                        i.   A proposed schedule should be made for completion of the specialty rotations on anesthesia, pathology, medicine/emergency critical care, and radiology. It is recommended that two weeks of off-clinic time include a specialty rotation in anesthesia during the first year. Pathology can be difficult to schedule, so should be planned well in advance.

                        ii.   The resident should identify a research project. The resident's mentor for research project does not have to be the Resident Advisor.

                        iii.  The program plan should include a time line for presenting 6 different seminars during the program. It is recommended that 2 seminars be presented each year.

                  e.   The Year 1 resident is typically assigned to 40 weeks of surgery rotations and 8 weeks off-clinics. (Four weeks of off-clinic time are generally scheduled during the last half of the 1^st year.) The remaining 4 weeks occur during the winter and spring holidays, and will be assigned based on the needs of the hospital. Requests for specific clinic rotations or off-clinic time (for research, out-rotations, professional meeting, or vacation), should be requested as soon as these preferences are known.

                  f.   The resident will participate in clinical service, emergency duty, rounds/conferences, and clinical teaching as described above in section II. E. "Duties and Responsibilities".

                       i.   The resident is expected to meet with his/her assigned faculty member at the beginning, middle, and end of each clinical rotation to establish responsibilities and assess progress.

                        ii.   Attendance at continuing education courses related to veterinary surgery is highly recommended. In general, the second year resident(s) will be assigned to clinical duty during the ACVS Symposium. This may be subject to change depending on resident numbers. However, every effort will be made to allow each resident to attend ACVS twice during the three year program, with emphasis on attendance during the third year.             

                  g.   The Resident Advisor and resident should meet at the beginning and end of each off-clinic period to discuss goals and assess progress for those weeks.

                  h.   The resident should provide a written proposal for his/her research project to the Surgery Residency Committee by February 1^st. The committee will accept, modify or reject the proposal. A formal proposal may need to be prepared and submitted for outside funding of research. Funding may be requested individually (for pilot research) or in conjunction with a faculty member. 

                  i.   The resident will participate in the departmental Faculty-Intern-Resident Seminar Program. No more than 2 major presentations will be required of a resident during the 1st year.

                  j.   The resident will participate in clinical and didactic teaching of veterinary student lectures and laboratories as requested.               

                  k.   The resident must begin documentation of training using the web-based Resident Training Log.  Items to be submitted include surgery cases, activity weeks, seminars, specialty service rotations, and supervisors. All items must be approved by the Resident Advisor and verified by the Program Director by February 1^st and August 1^st. 

                  l.   A performance and progress review will be held with the Resident Advisor twice yearly. This may be done together with the Surgery Residency Committee. The Resident Advisor will complete an online Semi-Annual Performance Review, which will be verified by the Program Director before February 1^st and August 1^st.

            2.   Second-Year Surgery Resident

                  a.   The Year 2 resident is typically assigned to 36 weeks of surgery rotations and 12 weeks off-clinics. The remaining 4 weeks occur during the winter and spring holidays, and will be assigned based on the needs of the hospital. Requests for specific clinic rotations or off-clinic time (for research, out-rotations, professional meeting, or vacation), should be requested as soon as these preferences are known.    

                  b.   The resident will participate in clinical service, emergency duty, rounds/conferences, and clinical teaching as described above in section II E. "Duties and Responsibilities".

                        i.    The resident is expected to meet with his/her assigned faculty member at the beginning, middle, and end of each clinical rotation to establish responsibilities and assess progress.

                        ii.   Attendance at continuing education courses related to veterinary surgery is highly recommended. In general, the second year resident(s) will be assigned to clinical duty during the ACVS Symposium. This may be subject to change depending on resident numbers.

                  c.   The Resident Advisor and resident should assess progress of research and specialty rotations, and schedule the best use of the off-clinic time for the remainder of the residency. The off-clinic time will be scheduled to meet the needs of the resident and the department by the best available compromise. The Resident Advisor and resident should meet at the beginning and end of each off-clinic period to discuss goals and assess progress for those weeks.

                  d.   Continue with research project and publication preparation. In general, data collection and analysis should be completed during the 2nd year, and submitted for presentation in abstract form at ACVS either in the 2^nd or 3^rd year.

                  e.   The resident will participate in the departmental Faculty-Intern-Resident Seminar Program.

                  f.   The resident will participate in clinical and didactic teaching of veterinary student lectures and laboratories as requested.              

                  g.   The resident will maintain the Resident Training Log. All items must be approved by Resident advisor and verified by Program Director by February 1^st and August 1^st.

                  h.   A performance and progress review will be held with the Resident Advisor twice yearly. This may be done together with the Surgery Residency Committee. The Resident Advisor will complete an online Semi-Annual Performance Review, which will be verified by the Program Director before February 1^st and August 1^st.                       

            3.   Third-Year Surgery Resident

                  a.   The Year 3 resident is typically assigned to 40 weeks of surgery rotations and 8 weeks off-clinics. The remaining 4 weeks occur during the winter and spring holidays, and will be assigned based on the needs of the hospital. Requests for specific clinic rotations or off-clinic time (for research, out-rotations, professional meetings, or vacation), should be requested as soon as these preferences are known.  

                  b.   The resident will participate in clinical service, emergency duty, rounds/conferences, and clinical teaching as described above in section II E. "Duties and Responsibilities".

                        i.   The resident is expected to meet with his/her assigned faculty member at the beginning, middle, and end of each clinical rotation to establish responsibilities and assess progress. 

                        ii.   The resident may be placed in charge of a clinical surgical service and student group (with supervision by an ACVS diplomate) for up to 8 weeks  (with mutual agreement of the resident, his/her advisor, and the Surgery Residency Committee).

                        iii.   Attendance at continuing education courses related to veterinary surgery is highly recommended. Every effort will be made to allow the resident to attend the ACVS Symposium. 

                  c.   The Resident Advisor and resident should assess progress of research and specialty rotations, and schedule the best use of the off-clinic time for the remainder of the residency. An external rotation (human hospital or specialty veterinary referral practice) may be considered for 1 to 4 weeks during off-clinic time in the 3^rd year. The off-clinic time may not be taken during the last 8 weeks of the year without approval of the Surgery Residency Committee. The Resident Advisor and resident should meet at the beginning and end of each off-clinic period to discuss goals and assess progress for those weeks.

                  d.   Continue with research project and publication preparation. All data analysis for the research project should be completed by December 1^st, and manuscript preparation should be started. Research projects should be written in final form for submission to a refereed journal by February 1^st. The manuscript must be accepted by an approved journal prior to August 1^st. Satisfactory completion of a research project is required for residency certification.

                  e.   The resident will participate in the departmental Faculty-Intern-Resident Seminar Program. The resident should present his/her completed research in a departmental or surgery section seminar by June 1^st.

                  f.   The resident will participate in clinical and didactic teaching of veterinary student lectures and laboratories as requested.

                  g.   The resident will maintain the Resident Training Log. All items must be approved by Resident advisor and verified by Program Director by February 1^st and August 1^st.       

                  h.   A performance and progress review will be held with the Resident Advisor twice yearly. This may be done together with the Surgery Residency Committee. The Resident Advisor will complete an online Semi-Annual Performance Review, which will be verified by the Program Director before February 1^st and August 1^st.

                  i.   Read updated ACVS Credentials Application Guidelines, which are usually available in March.

                  j.   Application to take the ACVS certifying examination is due by August 1^st. The resident should plan in advance to get necessary signatures and review, as some faculty may not be available in July.

IV. Resident Advisors and Supervisors

      A.   Resident Advisor

            1.   Within 90 days of beginning the residency, the resident shall choose a small animal surgery faculty member, who is an ACVS diplomate, to be his/her Residency Advisor. The resident's choice of an advisor must be acceptable to the Program director and the Surgery Residency Committee.

            2.   The Resident Advisor will file "Registration of Resident Advisor" (ACVS form 1b) with the ACVS within the first calendar quarter of the initiation of the program. A copy will be given to the resident, who must keep it on file in order to submit with the Credentials Application.

            3.   As soon as the Resident Advisor has been identified, the resident is expected to consult with him/her regarding development of an individual residency plan. The Resident Advisor will ensure that the resident is aware of all requirements of the residency program and options that are available.

            4.   The Resident Advisor will supervise completion of the residency requirements throughout the program.

            5.   The Resident Advisor will communicate appropriate feedback to the resident regarding his/her continued progress in the program, whenever appropriate throughout the program.

            6.   The Resident Advisor will hold performance and progress reviews with resident twice yearly (January and July). This is typically done together with the Surgery Residency Committee. On these occasions, the Resident Advisor will concurrently inform the Surgery Residency Committee about the resident's progress.

            7.   The Resident Advisor will approve resident's log items (surgery cases, activity weeks, seminars, specialty rotations) and complete Semi-Annual Performance Reviews online (verifying resident rounds attendance and satisfactory program progression) no later than February 1^st and August 1^st each year.

      B.   Responsibilities of the Head of Department and Section Chiefs

            1.   Notify the resident of his/her assigned clinical teaching responsibilities (i.e., laboratory instruction, didactic lectures, etc.).

      C.   Responsibilities of Program Director

            1.   Submit a "Program Director's Statement" (ACVS form 1a) to the ACVS office within 30 days of the start of the resident's program, along with a matriculation fee. (The resident will receive a copy of the Program Director's Statement", and must keep it on file in order to submit it with the Credentials Application.) After the form and fee have been received by the ACVS, the resident will have access to the Resident Training Log.

            2.   Ensure the resident has a Resident Advisor, and help them develop a training plan.

            3.   Verify the online Semi-Annual Performance Review, which has been approved by the Resident Advisor, no later than February 1^st and August 1^st.

            4.   Initiate program completion in the Resident Training Log at the end of the residency.