Chief's Clinic and Service at Hartnett Health Services
Abington Chief residents have the unique opportunity to experience autonomous surgical practice while under careful supervision by the faculty. This experience includes office hours, endoscopic block time, OR block time and Acute Care Surgery.
The five PGY5 chief residents have dedicated surgical clinic office hours each Thursday afternoon in the Hartnett Health Services Ambulatory Clinic. This clinic houses 18 medical and surgical specialties and provides care for the uninsured and underinsured in our community. Office schedules include new patients, postoperative patients, follow ups, and minor in office procedures. The practice covers general, vascular, colorectal, thoracic, breast, and plastic surgery patients. Each chief can see up to 18 patients per session. The chiefs are expected to function as a practice and learn about not only the clinical care of the pre-op and post-op patient, but also about practice management issues including insurance requirements and precertification, cross coverage of partners, office staff/time management, and administrative requirements. The PGY4 residents cross cover chief absences when needed in preparation for running their own clinic as a PGY5. Office hours are overseen by an assigned faculty member who reviews all in-office management decisions.
Chief residents have block time in which their elective cases can be scheduled. The chief can select the faculty member of their choice to staff the case, and the faculty provide as much autonomy as is safe while encouraging junior residents to scrub either as assistants or junior surgeons. This experience provides opportunity to hone the often overlooked “unseen skills”, including optimal positioning, adequate draping and effective retraction, while encouraging development of intraoperative teaching skills.
Endoscopic block time is also available, and the clinic has a robust screening colonoscopy program in addition to scheduling both diagnostic and therapeutic pre/postoperative endoscopy.
As the chief resident is the “primary surgeon” in contact with his/her patients, attention to detail and “ownership” of the patient across the care continuum is essential. For this reason, chief clinic and OR responsibilities supersede all other clinical responsibilities, and elective cases are scheduled around the resident’s availability.
“Chief's” patients admitted for non-elective surgery are managed by the chief resident of the Acute Care Surgery service (or subspecialty service as needed) with similar autonomy under supervision regarding perioperative and intraoperative management. These patients are then transitioned to follow with their chief resident in the chief clinic after discharge to guarantee continuity of care.
PGY5 chief residents each see 250-300 office visits per year, schedule approximately 35 endoscopies, 45 elective surgical cases and over 50 urgent/emergent surgical cases via the Chief Resident Clinic and Service.