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Program Coordinator

Dr. Simon Roe
Phone: 919.513.6334
Email: simon_roe@ncsu.edu

Small Animal Surgery Residency

Introduction

The Small Animal Surgery Residency Program at NCSU offers a diverse training experience, with the goal of producing a competent surgeon who can provide high quality professional services in a private or academic setting, develop creative approaches to clinical problems, and apply scientific technique to advance knowledge in surgery. It is structured so that, with diligence, residents will meet all the requirements of the ACVS. Clinical rotations involve the Orthopaedic, General Surgery and Neurology Services at the NCSU Veterinary Teaching Hospital and the Veterinary Specialty Hospital of the Carolinas (VSH). Residents will log approximately 700 cases over their three years and meet all ACVS case number requirements. There are 10 program faculty and 3 contributing faculty (see below). Primary supervision is provided on over 80% of cases. Faculty encourage the residents to develop their problem-solving skills. They are assigned a Chief Resident block in Orthopaedics, Soft Tissue and Oncologic Surgery in their third year, in which they have primary responsibility for the service.

Time off clinics is provided to complete the special rotations in Internal Medicine, Radiology, Pathology and Anaesthesia. Residents are required to publish a paper that is the result of original research performed during their program. They are encouraged to develop their own idea and prepare a grant for either external or internal funding. They choose the faculty member who can best facilitate their project. It is important that this process begin within the first few months of the program.

The resident will also be expected to pursue independent study with special emphasis on current surgical literature. A weekly Journal Club focuses on reviewing current literature in the required journals. Surgery rounds will be held weekly. Residents will participate in topic discussions with supporting current literature and a monthly Morbidity-Mortality review. Orthopaedic rounds will also be held weekly. They will be presentation of recent interesting cases, review of pertinent literature, or review of neurosurgical cases or topics. House Officer Rounds are also held weekly, and residents are expected to attend most of the small animal related topics (surgical and non-surgical presentations). NCSU Libraries provides access to ACVS Examination Reading List resources in addition to many other relevant resources.

Residents are encouraged to attend a CE or training course each year of their program. Examples would be the ACVS Symposium or the ASIF Surgical Fixation of Fractures, arthroscopy/laproscopy, or external fixator courses.

A Master of Specialized Veterinary Medicine (MSpVM) degree program is available for interested individuals. An ethics and a statistics course are the only requirements beyond the commitments of the residency program.

Year I

The major impetus during the resident's first year of training will be the development of diagnostic and technical skills. This will be accomplished by daily interchange with the staff surgeons and other specialists, and the diversity of clinical cases. Consultation with and supervision by the staff surgeons will be the mainstay of this phase of the training program. In addition, participation in resident seminars, student rounds, specialty rounds, and journal club will be required. It is suggested that the anesthesia and/or the internal medicine rotation be taken during the first year. The resident will spend 80 hours in each specialty. The resident will function in the Teaching Hospital Monday through Friday at least 8 hours daily. He/she will have responsibility for hospitalized surgical cases on the weekend, which represents a commitment of at least two to five hours. It is anticipated that the resident will be involved in hospital duties approximately 50 to 60 hours a week. The resident will participate in student rounds and will be expected to contribute to rounds in a didactic manner when necessary, and be knowledgeable of current literature pertaining to cases discussed. The resident will develop sufficient teaching skills to direct rounds and lead students through a problem-oriented approach to solving surgical problems. There are two surgery services that collaborate as needed. The Soft Tissue and Oncologic Surgery service operates on Monday, Wednesday and Friday and receives on Tuesday and Thursday mornings. On Monday, the Soft Tissue and Oncologic Surgery service handles emergency soft tissue cases, consultations and referral calls. The Orthopaedic service receives orthopaedic cases on Monday and Wednesday mornings and operates on Tuesday, Thursday, and Friday. Each service is headed by a senior clinician who works with the surgery resident and/or the intern assigned to surgery. Receiving afternoons are occupied with case workups and select surgeries when necessary. The development of neurosurgical skills occurs during participation in the Neurology service, while rotating at VSH, and by involvement in the neurosurgical emergency schedule. On certain cases, the resident will supervise or be assisted by a fourth-year student or the intern. On cases exceeding the resident's capability, he/she will be supervised by or act as first assistant to the faculty surgeon. The resident and student will care for those cases operated with the faculty surgeon. The student, under the resident's supervision, will care for those cases operated with students. The resident will maintain a surgery log using the ACVS web-based system on all operated cases. The first-year resident will rotate on surgical call with the other surgical residents. A faculty clinician or experienced resident will be assigned to provide necessary backup support. The first-year resident will often be required to assist in supervision of junior veterinary students in the operative laboratory during fall and spring semesters. This experience will provide exposure to common surgical procedures and the opportunity to view normal anatomic variations.

Research Project

The resident will be expected to identify a research project after consultation with the surgery and other CVM faculty, and to have at least outlined the timetable for completion of the project. Residents will be strongly encouraged to begin the project in the first year. Funding for projects may be available through the faculty mentor, but often the resident will be required to prepare a grant proposal to obtain external (ACVS, AVMA, AOVet, etc) or internal funding.

Year II

The second-year resident will continue participation in the teaching hospital surgery program. The resident will continue on the emergency surgery assignment with the first- and third-year surgery residents. It is suggested that the resident complete their radiology rotation during this year. The objectives of this rotation are to 1) develop proficiency in routine radiographic techniques including equipment operation and positioning, 2) develop competence in the more common special procedures, and 3) enhance and expand on radiographic interpretive skills. The above objectives will be met through daily participation in the small animal activities of the radiology section for 2 weeks during the second year of their program. A total of 80 hours contact time is required throughout the residency. The resident will participate in the routine radiographic case load, assist with and/or perform the more common special procedures, make decisions relative to radiographic quality, positioning, views, and supplementary studies needed, participate in daily discussion of radiographs, and review material in the radiographic teaching file. The resident must participate in the activities of the clinical pathology and/or gross pathology programs for a total of 80 hours. The objectives of this rotation are to 1) develop an understanding of general pathologic mechanisms, especially those relating to surgery, i.e., inflammation and repair, 2) acquire limited ability in necropsy and histological techniques, and 3) develop appreciation for proper history taking, lesion description, and tissue handling related to the surgical specimen. This time can also be used for the resident to review autotutorial programs available in clinical pathology. The resident is expected to consult with the pathologist regarding the visual interpretation of exfoliative cytological smears, abnormal blood smears, urine sediments, and biopsies from cases he/she presents to the laboratory. The clinical pathologists are also available for routine consultation regarding laboratory data and laboratory tests. The resident is expected to consult with the pathologist who necropsies his/her cases. The resident should review both the gross and microscopic lesions with the pathologist. Four weeks may be spent in other resident teaching institutions or obtaining other surgical experience. The objective is to broaden exposure to operative management principles and techniques. This includes veterinary and human medical institutions. The second-year resident will also assist in supervision of junior veterinary students in the operative laboratory during fall and spring semesters.

Research Project

The bulk of the research should be completed, the evaluation of the results performed, and the first draft of the paper prepared during this year. This schedule is essential if the resident wishes to have their credentials accepted by the ACVS at the August evaluation that immediately follows the completion of the residency. Faculty will assist the resident in achieving this goal.

Year III

The third year of the residency program is similar to the second. Time will be spent completing any outside rotations. The unique aspect of the third year of training will assigned as Chief Resident for the Soft Tissue and Oncologic Surgery service. They will be expected to direct the service in the same manner as the faculty surgeon. One of the faculty will review all decisions on cases each day, and will be available for consultation and assistance when needed.

Research Project

The publication must be submitted early in the third year to ensure that it will be accepted by the time credentials are submitted (August following completion). Residents are also expected to submit an abstract to the ACVS Residents Forum.

Evaluation of the Resident

The following parameters will be considered in the evaluation process: cognitive learning, attitude, and psychomotor skills. The evaluation process will include evaluation of each block by the senior clinician the resident is assigned to, audit of case records, consultation with other staff members who have contact with the resident, direct observation of the resident's performance in the operating room, tabulation of the diversity of case material with regard to the body systems, and review of case complications and mortality. The resident will maintain a case log that conforms to the requirements of ACVS. Active senior faculty participation will be tabulated. The resident will complete all medical records in a timely manner. There will be a biannual evaluation of each resident by the entire surgical faculty.

Application

This residency participates in the American Association of Veterinary Clinicians’ (AAVC) Veterinary Internship and Residency Matching Program (VIRMP) when a position is available. Application information and procedures are available at http://www.virmp.org/

The NCSU Small Animal Surgery Residency program frequently receives a large number of applications from candidates with a wide range of experiences. To assist candidates in preparing their application, they should consider their strengths in the various areas outlined below. Aspects of an application that are considered in the selection process include (but are not limited to):

Strong preference will be given to candidates with a good academic record, proven research experience, and highly supportive letters of reference from ACVS diplomates. These letters must detail the surgical and research experience of the applicant, their ability to work within a team, and their industriousness. A desire to pursue an academic career must be well articulated in the letter of intent. International applicants will be considered, but they will need to demonstrate extensive clinical and research experience to be competitive. After review of the applications, interviews will be offered to the top candidates in late December or early January. Those applicants interested in visiting NCSU prior to this period should send a copy of your letter of intent and CV, and the email addresses of three references, via email to Dr. Simon Roe. After review by the NCSU faculty, the applicant will be advised of their competitiveness and, if appropriate, a visit date organized. Not all faculty will be available for all visits.

Any questions pertaining to the residency program should be directed to:

Dr. Simon Roe
Professor, Orthopaedic Surgery
North Carolina State University
4700 Hillsborough St., Raleigh, NC 27606
Phone: (919) 513-6334
E-mail: Simon_Roe@ncsu.edu

The surgeons responsible for resident training are:

Simon Roe, BVSc, PhD, Diplomate ACVS, Program Director
Professor, Orthopaedic Surgery

Denis Marcellin-Little, DEDV, Diplomate ACVS and ECVS
Professor, Orthopaedic Surgery

Kyle G. Mathews, DVM, MS, Diplomate ACVS
Professor, ST & Onc

Duncan Lascelles, BVSc, PhD, Diplomate ACVS and ECVS
Associate Professor, Orthopaedic Surgery

Gary Spodnick, DVM, Diplomate ACVS
Chief of Surgery, VSH

Brian Trumpatori, DVM, Diplomate ACVS
Staff Surgeon, VSH

David Lee, DVM, Diplomate ACVS
Staff Surgeon, VSH

Contributing Faculty

Karen Muñana, DVM, Diplomate ACVIM (Neurology)
Associate Professor, Neurology

Natasha Olby, BVSc, PhD, Diplomate ACVIM (Neurology)
Associate Professor, Neurology

Chris Mariani, DVM, PhD, Diplomate ACVIM (Neurology)
Assistant Professor, Neurology

Dr. Peter Early, DVM, Diplomate ACVIM (Neurology)
Assistant Professor, Neurology

Elizabeth M. Hardie, DVM, PhD, Diplomate ACVS
Head, Department of Clinical Sciences
Professor, General Surgery