That message is a powerful motivator each year for its highly competitive class of approximately 100 residents—among the largest in the country—who will go on to fellowships and key surgical leadership positions in hospitals and medical centers across the country.
“What we offer our residents are the tools to perfect their surgical craft within a mentored, team-based setting,” says Celia Divino, MD, Chief, Division of General Surgery and the Stanley Edelman Professor of Surgery at the Icahn School of Medicine at Mount Sinai, who is the Director of the General Surgery Training Program. “This means equipping trainees with the technical and cognitive skill sets that go hand-in-hand with delivering competent, compassionate care to each of their patients. In short, we’re committed to providing residents with an education that is both comprehensive and socially conscious.”
Among the vehicles for ensuring this mission is the Mount Sinai Center for Surgical Simulation, Robotics, and Artificial Intelligence. At this advanced center on the campus of The Mount Sinai Hospital in New York City, surgery residents hone their surgical skills and simulate team-based approaches. Using patient simulator manikins, they learn how to manage different clinical scenarios, such as bleeding, sepsis, and trauma under the supervision of faculty. Working with high-definition laparoscopic and robotic platforms, and augmented and virtual reality simulators, residents acquire the necessary skills and discipline in preparation for their encounters with patients. To maximize their learning, training sessions are conducted in a mock operating room to simulate the real environment.
~ 100
Number of General Surgery residents at the Icahn School of Medicine
From left: Residents Julian Howland, MD; Rashid Logan, MD; Tina Doan, MD; and Alexandra Agathis, MD; with Fred Wu, Simulation Program Manager, in the Mount Sinai Center for Surgical Simulation, Robotics, and Artificial Intelligence.
From left: Celia Divino, MD, with Julian Howland, MD, utilizing augmented reality technology, guided by Dr. Divino in real time.
“The Surgical Simulation Center replicates the entire realm of surgical experience, from basic suturing to advanced robotic surgery, and from routine procedures to true emergencies, such as a bleeding patient,” says Dr. Divino. “We’re fostering the type of teamwork, interactions, and communications among staff that translate into improved levels of safety and care that we provide to patients.”
Residents with Celia Divino, MD, in the Mount Sinai Center for Surgical Simulation, Robotics, and Artificial Intelligence.
According to Dr. Divino, Mount Sinai is one of the very few academic sites able to offer sophisticated trauma training through the Cut Suit Trauma Surgical Simulator, a system that replicates, in a most realistic way, a trauma patient. Under the expert guidance of attendings, residents learn how to treat stab and gunshot wounds and other life-threatening emergencies, starting with the injury, to treatment enroute to the hospital, and including surgical intervention.
“There aren’t a lot of residency programs apart from Mount Sinai’s that give you such resources to just practice and get the repetition you need to feel confident, precise, and sharp when you go into the operating room with live patients,” says Alexandra Agathis, MD, a fourth-year resident who is focused on a career in laparoscopic surgery.
Mount Sinai is one of very few academic sites able to offer sophisticated trauma training through the Cut Suit Trauma Surgical Simulator, a system that replicates, in a most realistic way, a trauma patient.
Of equal importance, Dr. Agathis adds, is the opportunity to forge tight bonds with other residents in the program to facilitate the kind of teamwork and communications that are critical to optimizing patient safety, care, and outcomes. “There’s a level of comfort and confidence you can’t get unless you’re working closely with your colleagues,” she says. “And the team-based, low-stress setting we train in is the perfect environment to promote that chemistry.”
Another distinguishing feature of the program is the opportunity to participate in the robust Global Surgery Program of the Department of Surgery. Unique to the program is the opportunity for third-year residents to do a month-long clinical rotation at the Kyabirwa Surgical Center (KSC) in the East African Republic of Uganda.
The Kyabirwa Surgical Center in the East African Republic of Uganda.
A first-of-its-kind ambulatory surgical facility for that region of the world, KSC provides outpatient surgery to a deeply underserved community where even the most common of procedures—hernia repair, appendectomy, cataract removal, colonoscopy, wound management, burn treatment, hemorrhoid removal, and cancer biopsies, for example—were unavailable before the facility was built with philanthropic support. Residents, for their part, face the challenge of working in a low-resource, self-sustaining clinical environment that is run by the local community. They also find themselves engaged in onsite longitudinal research projects, gaining an understanding of the barriers to health care and innovative technologies that could be applied to this indigenous surgical environment, where nearly everything must be sterilized and reused.
“We don’t go there just for the purpose of doing surgery in another country,” points out Linda Zhang, MD, Professor of Surgery and Director of the Global Surgery Program who manages resident activities at the Uganda site. “It’s about cultural exchange and competency, and the collaborative spirit that emerges from these rotations. Residents are able to deepen their understanding of global health issues and learn the importance of compassionate care for people everywhere.”
Linda Zhang, MD, with a Ugandan surgeon learning laparoscopy.
Residents become immersed in one-on-one education as part of their surgical duties. “Patients typically have to walk a long way to get to the center and, when they arrive, their health literacy is pretty low,” says Dr. Zhang, who trained in the Dominican Republic as part of her own Mount Sinai surgical residency. “They have a lot of misconceptions about what surgery is, and so residents and the center staff must continually provide that fundamental education to patients.”
That thought is echoed by chief resident Julia Torabi, MD, who vividly remembers her visits to local towns and villages as part of her Ugandan rotation. “During these visits we provided health care education and, most importantly, discussed with patients the fears that often prevented them from engaging with the medical community,” says Dr. Torabi. Those discussions with villagers typically encourage them to obtain colonoscopies and other types of health screening available at the KSC.
At the Kyabirwa Surgical Center: Julia Torabi, MD, with Joseph Okello Damoi, MD.
For Dr. Torabi, the most memorable experiences revolved around being part of health care teams that visited the homes of patients following surgery. “We performed physical exams, changed dressings, discussed recovery times, and identified patients with potential postoperative complications,” she recalls. “They were extremely grateful for these visits and welcomed us into their homes. In addition to the practical experience we picked up, it was a wonderful way for us to learn about the Ugandan culture and customs.”