23
NOV
2014
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Orlando Health Colon & Rectal Residency Program

Welcome

Thank you for your interest in Orlando Health / Colon & Rectal Clinic of Orlando’s residency program in Colon & Rectal Surgery.

The Colon & Rectal PGY VI Residency Program is under the auspice of Orlando Regional Medical Center, Department of Graduate Medical Education but is based at the private practice of the Colon & Rectal Clinic of Orlando. The PGY VI residency was founded in 1990 and has maintained full accreditation from the ACGME Residency Review Committee (RRC) for Colon and Rectal Surgery. We have had 32 residents graduate from our program.

We offer three positions.

Successful completion of the residency program will qualify an individual for the Board examinations of the American Board of Colon and Rectal Surgeons.

Resident Experience

Residents participate directly in surgical cases at Orlando Regional Medical Center, a 581-bed facility located on the downtown campus, two blocks from the Colon and Rectal Clinic and Florida Hospital Medical Center. Rotations are delineated by the residents assigned faculty member rather than by institution. Fellows can expect to complete this one year program with 1000-1500 cases performed as resident or first-assistant.

The colorectal training program includes in-depth knowledge of all aspects of anorectal and colorectal disease including but not limited to office practice, hospital rounds, outpatient surgery, major abdominal surgery, endoscopic procedures, and anorectal physiology. A strong laparoscopic approach to colorectal diseases is also part of the curriculum. The residents learn various techniques of laparoscopic surgery through their rotations with different attendings. The teaching focus is also on advanced specialized training to evaluate functional disorders of the anal sphincter, rectum and pelvic floor. An anal physiology lab has been established at the CRC that includes evaluations of anal manometry, EMG, defecography, colonic transit studies and therapeutic modalities including biofeedback with an on-site therapist. Exposure to rectal and anal endosonography is available.

Goals for this one-year program

  • The resident must acquire an extensive, sound knowledge base in the clinical science of colon and rectal surgery and should become especially well versed in the diagnosis and management of diseases and disorders of the colon, rectum and anus.
  • The resident must acquire a fundamental knowledge base in the basic sciences applicable to colon and rectal surgery.
  • The resident must develop, through technical training and operative experience, competence to execute the operative and non-operative procedures intrinsic to the practice of colon and rectal surgery.
  • The resident must develop the necessary skill in clinical decision-making to become a safe and effective practitioner of colon and rectal surgery.
  • The resident must demonstrate the desire and ability to care for his or her patients in a competent, responsible, compassionate and ethical manner and to serve society by always demonstrating professional integrity, intellectual honesty and social responsibility.
  • Provides a training curriculum that will qualify post general surgery residents for certification by the American Board of Colon & Rectal Surgery.
  • The resident must be competent in the six areas listed to the level expected of a new practitioner:
    • Patient Care
    • Medical Knowledge
    • Interpersonal Communication Skills
    • Practice-Based Learning and Improvement
    • Professionalism
    • System-Based Practice

Clinical Rotations

Primary full-time teaching responsibilities are shared by attending physicians Andrea Ferrara, M.D., Paul Williamson, M.D., Joseph Gallagher, M.D., Samuel DeJesus, M.D and Rene Mueller, M.D.. Part-time faculty include Sergio Larach, M.D., and Thomas Blake, M.D. All faculty members are board certified or board eligible in the specialty of colon and rectal surgery. Residents participate directly in surgical cases at Orlando Regional Medical Center and Florida Hospital Medical Center under the immediate direction and supervision of their assigned attending for the month. Rotations are delineated by the residents assigned faculty member rather than by institution.

The resident rotation functions as a preceptorship with their assigned attending who provide adequate supervision of the residents’ activities. Residents are scheduled to see office patients on an average of twelve hours per week based on their assigned attendings patient office schedule. The resident’s consult with patients on first evaluation, subsequent pre-operative evaluation, surgery, post-operative care, and management of complications. Together the resident and attending perform the physical exam, endoscopy and if needed, office surgery. After surgery, the residents provide post-operative care and the management of complications.

Outpatient Experience

Outpatient experience is provided primarily at the Colon and Rectal Clinic (CRC) of Orlando and the Surgical Licensed Ward (SLW). The SLW is a modern ambulatory care facility for diagnostic and outpatient operative care. This facility is located on the downtown campus. Residents spend the equivalent of three to four half-days in this setting. This gives them experience in a large number of colonoscopy and outpatient rectal surgeries. Approximately 1700 diagnostic and therapeutic colonoscopies are performed annually which develops the necessary competence in the use of this procedure for the resident to qualify as an expert in this field. They also have first hand training experience in an outpatient facility in developing the skills in patient evaluation, examination, office treatment and care after surgery.

The residents are also required to staff the Surgery Faculty Practice Clinic (SFPC) under the supervision of the attending assigned for the week. Patients are referred for diagnosis, treatment, pre-operative, and post-operative consultation. The residents work up the patients then present their findings with their treatment plan to the attending. The residents are not only responsible for pre-operative and post-operative follow up on their patients, but also for colonoscopy and surgery.

Academic Curriculum

Monday 7:30 am - 8:30 am

Clinical Decision Making (1st and 3rd of each month)
Topic Review (2nd of each month)
Research Project Meeting (4th of each month)

Wednesday 7:30 am - 8:30 am
Colon & Rectal Tumor Board (each 4th month)
Thursday 7:30 am - 8:30 am
Topic Review (1st of each month)
Pathology (2nd of each month)
Radiology (3rd of each month)
Pelvic Floor Disorder (4th of each month)
CARSEP (5th of month)
Grand Round Review (4th or 5th every other month)
Friday 7:30 am - 8:00 am
Colon & Rectal Grand Rounds (every other month)

Program Features

  • -190 – 240 major abdominal procedures
    - 250 - 300 anorectal procedures
  • Colonoscopy (per resident each year)
    - 135 – 150 colonoscopies
    - 50 – 100 polypectomies
  • Center for Pelvic Floor Disorders
    The resident experience includes patient interviews, anal physiology testing, anal and rectal ultrasound and interpretation of anal physiology tests. Patients are evaluated in the Center for Pelvic Floor Disorders. Dr. Ferrara is the Director of the Pelvic Floor Disorders.
  • Endorectal Ultrasound
    Each year, 1,800 endorectal ultrasound examinations are performed by Dr. Ferrara, Dr. DeJesus, Dr. Gallagher, and Dr. Williamson for staging of rectal cancer or evaluation of incontinence and other anorectal disorders. Hands-on experience in performing this procedure and interpreting the images is structured into the program.

Clinical Research

  • Each resident must complete a research project to be submitted in abstract form for consideration of presentation at the annual meeting of the American Society of Colon & Rectal Surgery and SAGES
  • The manuscript of this research must be completed and submitted for consideration of publication in a peer-reviewed journal prior to the conclusion of the residency year.

Current areas of research

  • Transsphincteric Approach to Difficult Rectal Pathology
  • Comparison of lymph node harvest following neoadjuvant therapy in rectal cancer: complete pathologic response vs. non-responders
  • Stapled Hemorrhoidectomy (PPH): Role of Concomitant Excision of External Disease
  • Hand-Assisted Laparoscopic Colectomy for Colon Cancer: Early Clinical and Oncologic Outcomes Comparison with Case-Matched Open Colectomies
  • Initial Follow up Results for the Stapled Transanal Rectal Resection (STARR) Procedure for obstructed defecation
  • Developing a small animal model for the study of laparoscopic colon surgery
  • A Comparison of Hand Assisted Laparoscopic (HAL) and Laparoscopic Colectomy for the Treatment of Diverticular Disease
  • Review of 15 year experience comparing laparoscopic treated rectal cancer with case matched open Procedures
  • Hand-Assisted Laparoscopic surgery (HALS) and Lighted Ureteral Stents (LUS) for Complicated Sigmoid Diverticulitis: A Combination of Technologies with Decrease Surgeon Stress and Increase Patient Safety
  • C3H Mice Animal Model Investigation - A novel approach to creating orthotopic colon cancer in mice

Interview/Application Information

Interviews are by invitation only.

The interview process at the Colon & Rectal Clinic of Orlando consists of one full day. We recommend Hotel options located downtown near the Colon & Rectal Clinic of Orlando, 110 W. Underwood St., Orlando, FL 32806-1132. You will receive the discount rate when you identify yourself as being here for Orlando Health related business upon making your reservation. You can rent a car or cab to our clinic.

Residency Application Process

ERAS®—the Electronic Residency Application Service—is a service that transmits residency applications, letters of recommendation, Dean's Letters/MSPE, transcripts, and other supporting credentials from applicants and medical schools to residency programs using the Internet via www.aamc.org. The Colon & Rectal Clinic of Orlando/ Orlando Health System requests a completed online application, a personal statement, curriculum vitae, a letter of recommendation from the Program Director of your general surgery residency program, two additional letters of recommendation, and a wallet size photo.

The deadline for applications is August 15. Our interview committee will meet to determine which applicants will be invited for an interview. Invitations to interview will begin the end of August. Interviews will be held in September and will conclude the last week of October. Residents must be able to apply for and receive a Florida license to practice medicine upon acceptance into the program. Florida requires that applicants show they have obtained a passing score on the FLEX/National Board of USMLE examination Step I, Step II, & Step III, provided that said examination should have been taken within the ten (10) years immediately preceding the filing of the application for your license. An application for medical staff privileges at 3 hospitals will also need to be completed.

Salary / Benefits

Salary rates for residents are reassessed every year. To date, each annual evaluation has resulted in a salary increase. For 2007, PGY VI salaries are $49,700

Benefits

As an employee of Orlando Health, you are eligible for:

  • Life insurance equal to your annual stipend
  • Additional coverage for you and your family at very low premiums
  • A variety of low-cost medical and dental insurance options, including PPO and HMO plans and a mail order prescription service
  • At least 15 working days of paid vacation each year. Sick leave of 96 hours per year (both vacation and sick leave may be used for maternity leave.)
  • Membership in the Orlando Health Wellness Center for a nominal fee; includes fitness consultations, assessments, exercise classes, Stairmaster, Nautilus and massage.
  • Free parking for physicians

The Department of Medical Education offers the additional benefit listed below:

  • Cafeteria-style meals, at no charge, while on duty

Contact Us

If you require more information, you can reach us by e-mail at NJoiner@CRCOrlando.com or by phone at 407.422.3790 x 3021

Andrea Ferrara, MD
Colon & Rectal PGY VI Residency Program Director

Nancy Joiner
Academic Program Manager