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Clinical Fellowships

Colorectal Surgery Residency Training Program

The Section of Colon and Rectal Surgery at the University of Louisville is affiliated with five teaching hospitals, including:

• University of Louisville Hospital
• Norton Hospital
• Kosair Children's Hospital
• Jewish Hospital
• Veterans Administration Medical Center

With the exception of the VAMC, these hospitals are all located within a three-block area. Most are connected by skyways. Together, the hospitals represent a resource of more than a thousand beds, with the most up-to-date diagnostic and therapeutic facilities. Both the UofL J. Brown Cancer Center and Norton Cancer Center are located in the downtown Medical Center campus.

The Section of Colon & Rectal Surgery has garnered an outstanding reputation. One of its main strengths is the balance between complex abdominal surgery, anorectal pathology and endoscopy.

The section is the referral center for inflammatory bowel disease patients in Kentucky and southern Indiana. It also treats a large number of patients with both primary and recurrent colorectal cancer, as well as patients with simple and complex anorectal diseases.

Scope of Training
The aim of our program is to produce well-rounded, skilled operating surgeons who are committed to life-long learning. Fellows are taught by faculty on a one-to-one basis and perform surgery under faculty supervision. The majority of graduates are expected to go on to careers in academic surgery.

The strongest asset of our training program is the breadth of exposure to colon and rectal surgery. Residents complete the program with experience in complex tertiary referral re-operative surgery, endoscopy, laparoscopy, anorectal surgery, and physiology. Anorectal manometry, EMG with determination of pudendal nerve terminal motor latency, and endoanal and endo-rectal ultrasound are routinely available and performed by residents. Defecating proctography and transit studies are performed by radiologists, but interpreted by colon and rectal surgery residents.

Because we maintain a strong research program, trainees also participate in clinical trials and gain cutting-edge knowledge of new drugs and procedures.

Schedule of Rotations
Our training program offers a varied experience, along with some flexibility. The medical oncology rotation is a one-week rotation and occurs the first week in August, followed by a one-week pathology rotation. The current schedule of the faculty provides options to the resident so as to meet training requirements.

The resident typically has the following schedule:

There are no in-house calls after hours. However, residents must come to the hospital for emergency consults or surgeries. During the day, residents are responsible for rounding on patients, as well as overseeing the pre- and post-operative care of these patients. Sundays are free of clinical responsibilities.

Research Opportunities
The Department of Surgery at the University of Louisville School of Medicine offers outstanding research opportunities in the field of colon and rectal surgery, including clinical outcomes research and phase II and III clinical trials of new drugs and devices. An additional year of basic science research is optional.

Currently, our laboratory research is focusing on molecular biologic aspects of inflammatory bowel disease and colorectal cancer. We utilize a library of more than 1,000 DNA samples from patients with Crohn’s disease, ulcerative colitis, indeterminate colitis, familial adenomatous polyposis, and colorectal cancer.

Other areas of basic research are varied and include immune tolerance, photodynamic therapy of colorectal malignancy, and alterations in microcirculation and cytokine production in the presence of infection and tissue injury. Some of these projects are supervised in part by general and oncological surgeons. However, participation in any of the above is available to the colon and rectal surgery resident who wishes to pursue an additional laboratory research year. Advanced degrees (MBA, MPH and Ph.D) are also available, but, in most cases, are contingent on an additional 12- to 24-month commitment.

National Meeting Attendance
Each completing resident must submit one manuscript for publication in a peer reviewed journal and at least one abstract for presentation at a national surgery meeting. Residents also must attend the meeting of the American Society of Colon & Rectal Surgeons. Expenses are paid for by the Section. Other national meeting attendance is contingent upon having a paper on the program.

Colorectal surgery residents interact with general surgery residents and medical students. On Fridays, residents participate in teaching rounds at Surgery Grand Rounds. Afterwards, they attend the Resident Basic Science Conference with general surgery residents. A Colon and Rectal Surgery Conference takes place every Monday morning. This includes presentations by University faculty, Quality Improvement Conference, and Journal Club.

Because colon and rectal surgery cases are discussed at the Elective Surgery Morbidity & Mortality Conference of the General Surgery program, residents must attend these conferences quarterly. Attendance at the Critical Care/Basic Science Conference of the general surgery resident's program on Monday mornings is optional. The tumor board of the J. Graham Brown Cancer Center meets weekly.

We believe that the Colon & Rectal Surgery Training Program is one of the finest in the country. Should you have any questions about our program, please call or email us. We'd be happy to discuss program details with you.

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