More on History of our Department
More on History of our Department
More on History of our Department
Surgery Training and Education
More on History of our Department
History of our Department
In 1771, King George III granted a royal charter to establish The Society for The New York Hospital.1 Construction of the hospital was delayed by the start of the Revolutionary War. The Hospital finally opened in 1791 (Fig. 1). Wright Post, one of the first surgeons appointed to the hospital in 1792, was the first in America to ligate the femoral artery for the treatment of a popliteal aneurysm in 1796, the common carotid artery in 1813, and the subclavian artery for the treatment of a brachial artery aneurysm in 1817. He developed state-of-the-art surgical techniques for aneurysms, paving the road for the innovative work of Dr. Valentine Mott, a pioneer in vascular surgery, who achieved the astonishing record of treating 138 aneurysms by ligation, including one of the innominate artery in 1818, the first time in the history of surgery.1 In November 1846, only 1 month after Dr. W. T. G. Morton demonstrated the use of ether anesthesia in Boston, Dr. John Rodgers used ether anesthesia during the treatment of a perirectal abscess at The New York Hospital.
In 1898, Dr. Stimson wrote the charter of a new medical school, the Cornell University Medical College. Along with the medical school's first dean, William Polk, Stimson was instrumental in obtaining a gift of $1.5 million from the well-known philanthropist Colonel Oliver Payne to open the new medical college along First Avenue, between 27th and 28th Streets in Manhattan (Fig. 3). Stimson expanded the traditional surgical curriculum by adding bedside training sessions and laboratory research to the didactic lectures and, by 1908, residents would, for the first time in history, require a college education as a qualification for admission. Lewis Atterbury Stimson (Fig. 4) was named the first Chairman of the Department of Surgery at Cornell University Medical College, a position he held until 1917. It was during his tenure as Chairman that an agreement was signed in 1912 between The New York Hospital and Cornell University, which led to the building and opening of The New York Hospital and Cornell University Medical College at their present location on the Upper East Side of Manhattan in 1932 (Fig. 5).
Heuer trained many future leaders, including Bronson Ray and Victor Marshall, who became the chiefs of neurosurgery and urology, respectively; Herbert Conway, chief of plastic surgery, who trained Joseph Murray, Nobel Prize winner for medicine in 1990; and Preston Wade, a leading trauma surgeon and pioneer in accident prevention. Dr. Wade treated many of the burn victims of the Hindenburg disaster, designed the emergency room at New York Hospital, which became the prototype of those recommended by the American College of Surgeons, and was instrumental in convincing Congress to pass a law requiring the mandatory installment of seatbelts in cars. Heuer retired after 16 years in 1947 after training more than 100 surgeons; he was one of the founders of the American Board of Surgery.3
The history of transplantation at New York Hospital is rich and goes back to the beginning of the discipline. The first kidney transplant was performed by Dr. Edward Goldsmith in 1963. Dr. Lillehei performed the hospital's first cardiac transplant in 1968. A year later, the first interhospital and largest multitransplant operation in the world involving six organs was performed at our hospital.2 In 1996, the first pancreas transplant program in the tristate area was established in our hospital. In 2004, our surgeons were the first in the tristate area to perform minimally invasive islet cell transplants to cure Type I diabetes.
In 1996, David Skinner, an internationally renowned esophageal surgeon who had become the President of New York Hospital in 1987, expanded the hospital with a new 880-bed pavilion built over the FDR Drive in a most technological advanced engineering feat. Since then, an additional floor with 48 beds has been added to the initial construction (Fig. 8). In 1998, Dr. Skinner spearheaded the merger between New York Hospital and the Presbyterian Hospital of New York into one entity named NewYork-Presbyterian Hospital.
In 2001, Dr. Thomas Fahey III became the Director of the General Surgery Program, a responsibility that he continues to discharge with competence and passion. In 2004, Dr. Fabrizio Michelassi was appointed the Lewis Atterbury Stimson Professor and Chair of Surgery at Weill Cornell Medical College and Surgeon-in-Chief at NewYork-Presbyterian Hospital/ Weill Cornell Medical Center. In addition, the Department has expanded with appropriate recruitments in the areas of colorectal surgery and minimally invasive and bariatric surgery. These two areas of expertise have been recognized as two separate sections in general surgery.
As a result of this expansion, the Department of Surgery today counts over 40 full-time faculty members and 75 residents and fellows (Fig. 9). Most of our faculty members are nationally and internationally renowned in their respective fields and provide our patients with the highest quality, personalized care using state-of-the-art technologies and, when feasible, minimally invasive techniques to achieve the most successful surgical outcomes.
General Surgery Residency Program
Our general surgery residency program trains exceptionally qualified surgeons who have the skills and ability to function at the highest level and provide state-of-the-art, compassionate patient care. The program is under the supervision of the Chairman of the Department, the Program Director, and a large full-time and volunteer faculty. The faculty believes their mission is not only to produce technically superb surgeons but, in addition, to produce surgeons well grounded in the basic science of surgery and with clinical judgment to render complete care to the surgical patient. A broad exposure to all areas of general surgery is provided to ensure development of adequate clinical knowledge.
The General Surgery Program at NewYork-Presbyterian Hospital/Weill Cornell Medical Center is a 5year program and accepts 8 categorical and 18 preliminary surgical residents each year. The program is divided into three clinical stages of training.
The Postgraduate 1 and 2 Years
The emphasis during the junior surgical residency is the primary care of the surgical patient. The junior surgical residents are directly responsible for preoperative and postoperative care, with progressive operative responsibilities. Patient care is supervised by the more senior resident staff and the attending staff, which allows the junior surgical resident to take on the responsibilities of primary patient care in an atmosphere that fosters constant learning from more experienced surgical personnel. The junior resident becomes familiar with physiological and metabolic problems that face each surgical patient. Significant operative experience is obtained under the direct supervision of senior residents and attending surgeons. During the first year of training, resident rotations are 1 or 2 months long. The rotations include general surgery, surgical oncology, trauma surgery, vascular surgery, cardiothoracic surgery, and care of the burned patient with significant critical care/intensive care unit experience. Elective experience is available to complement the basic surgical training with exposure to plastic, orthopedic, urologic, otolaryngologic and neurologic surgery. During the second year, the resident continues preoperative and postoperative care and, in addition, takes on even more operative responsibilities. Additional experience in pediatric and transplantation surgery is gained during the second year. Rotations through the emergency room provide the junior resident with the opportunity to evaluate surgical patients with acute problems and gain further experience with acute care and outpatient surgical procedures. The hallmark of the junior surgical residents' training is a command of basic and intensive care of the surgical patient. Residents in the preliminary track are integrated fully into the junior surgical residency with variations in their rotation schedules to complement their area of concentration. Residents' on-call is generally limited in the first year because there is a night call rotation.
The Postgraduate 3 Year
The focus of experiences gained during this year is on the development of advanced surgical judgment in and out of the operating room. The transition from junior resident to Chief Resident is developed during this year as the senior resident assumes major responsibility for the day-to-day activities of the surgical inpatients, directly supervising the junior resident staff. Advanced elective and emergency surgery is performed by the third-year resident on the general and trauma services under the supervision of the attending surgical staff. This year plays a crucial role in the evolution of mature surgical judgment and technique.
The Postgraduate 4 and 5 Years
The Chief Resident hones his or her surgical judgment and skill during these years, but also assumes many other primary responsibilities. These include the supervision of junior and senior surgical residents in the overall care of surgical patients and the direct instruction of medical students and physician assistants assigned to their services. In the operating room, the Chief Resident becomes skilled with most general surgical procedures, gaining experience in the more complex surgical procedures, and is involved in the operative teaching of junior residents. The fourth-year resident serves as the Chief Resident on the pediatric and transplantation services at NewYork-Presbyterian Hospital as well as the general and trauma services at Jamaica Hospital. The fourth-year resident also serves as the primary operating fellow on the breast, head and neck, and thoracic surgical services at Memorial Sloan-Kettering Cancer Center. During the fifth year, the Chief Resident role continues on the general, vascular and trauma services at NewYork-Presbyterian Hospital. The fifth-year resident also serves as the primary operating fellow on the gastric, mixed tumor, and colorectal surgical services at Memorial Sloan-Kettering Cancer Center. Advanced elective time is available during the fourth year in gastrointestinal endoscopy, plastic surgery, and cardiac surgery. The Chairman of the Department of Surgery and the Program Director designate an Administrative Chief Resident from the group of fifth-year Chief Residents. The Administrative Chief Resident is responsible for assisting the Chairman and the Program Director in the overall administration of the residency.
Although not mandatory, many residents select to interrupt their 5-year clinical training and spend 2 to 3 years in a basic science laboratory setting; the innumerable basic science and translational research laboratories in the Departments of Surgery at Weill Cornell Medical Center and Memorial Sloan-Kettering Cancer Center offer adequate variety for residents to choose from. As a measure of the success of this research exposure, in the academic year 2007-2008, residents engaged in research delivered more than 40 presentations and published 68 journal articles and 6 book chapters.
The Surgical Residency Program at NewYork- Presbyterian Hospital/Weill Cornell Medical Center prides itself on training future academic surgeons. Graduates of the general surgery residency almost always proceed on to subspecialty fellowships (Table 1), spanning the entire gamut of general surgery sub-specialties (Table 2). Ultimately, the majority of our graduates take full-time faculty positions in academic medical centers around the country.
|TABLE 1. Career Paths of Graduates of the NewYork- Presbyterian/Weill Cornell General Surgery Residency, 2001-2008|
|TABLE 2. Fellowship Selection of NewYork-Presbyterian/ Weill Cornell General Surgery Residents, 2001-2008|
|Minimal access surgery||5|
|Plastic and Reconstructive||8|
|Trauma and Critical Care||3|
The Surgical Residency Program at NewYork- Presbyterian Hospital/Weill Cornell Medical Center has a long tradition of excellence that dates back to the beginning of surgery at The New York Hospital more than 2 centuries ago and is based on the academic fabric of the Department of Surgery at NewYork- Presbyterian/Weill Cornell. It continues to thrive as a result of the cutting-edge surgical procedures performed on a daily basis by the faculty of our department and the wealth of experience offered by rotations through the other integrated and affiliated hospitals. Although not mandatory, many residents select to interrupt their 5-year clinical training and spend 2 to 3 years in a basic science laboratory setting. Ultimately, the majority of our trainees choose full-time faculty positions in academic medical centers around the country as their first job.
- Pool EH, McGowan FJ. Surgery at the New York Hospital One Hundred Years Ago. New York: Hoeber; 1930.
- Leitman IM. The evolution of surgery at the New York Hospital. Bull N Y Acad Med 1991;67:475-500.
- Larrabee E. The Benevolent & Necessary Institution. Garden City, NY: Doubleday & Co; 1971.