Residency education in general surgery at UAB comprises five clinical years. Eight categorical residents are accepted into the program annually through the National Residency Matching Program. Residents have the option to complete two years of research, free of clinical duties. All house officers receive extensive training in preoperative evaluation in the clinic and hospital settings, intraoperative technique, postoperative and critical care management, and follow-up care. Residents train at four hospitals located within the downtown medical center - UAB Hospital, Birmingham Veteran's Affairs Hospital, UAB Highlands and Children's of Alabama.

First Year

The first-year categorical residents (PGY-1) rotate through four hospitals and share junior resident duties with first-year residents from other surgical disciplines. Their responsibilities include initial evaluation and treatment of patients, participating in rounds and conferences, attending clinics, operating on level-appropriate cases in the operating room, and serving as teachers and mentors to medical students on their surgical clerkships. The first year provides residents with a very broad training in one-month rotations. First-year residents are given responsibility for the comprehensive medical and surgical care of ward patients. Upon completing the first year, residents are very comfortable managing pre- and postoperative patient issues, clinic workups, and basic operative skills. The average resident logs over 200 major cases during their first year. Surgical oncology, GI surgery, pediatric surgery, and the VA hospital offer junior residents the greatest breadth of operative exposure. Most of the calls are in-house during the first year. Vascular, colorectal, trauma, minimally invasive, and surgical oncology first-year resident calls are covered during the week by a night float resident. Pediatric surgery call is generally every third or fourth night, while calls at the Veterans Affairs hospital occur every third night (home call). 

Second Year 

During the PGY-2 year, residents gain an increasing level of clinical independence and responsibility for patients overnight and in the ICU. The 5- to 7-week rotations during the second year include breast oncology, emergency general surgery, pediatric surgery, VA vascular, Highlands general surgery, as well as rotations in the trauma/burns and surgical intensive care units. Second-year residents act as mentors to interns on their ICU rotations, teaching procedures such as line placements, endoscopy, bronchoscopy, chest tube insertions, and dialysis access. Two rotations are also spent on night float, covering vascular and GI / Surgical Oncology services. Second-year residents gain increased exposure to laparoscopy and more complex general surgery cases. ICU rotations are covered by swing shifts, allowing residents to care for critically ill patients both during the day and at night while alternating with other residents without having to take 24-hour ICU call. In-house call varies by rotation, with the majority of rotations covered by night floats, during which day residents will cover every other weekend.

Three Year

The third year (PGY-3) of training offers residents continued advanced operative autonomy and transitions them into leadership roles within a team. An elective is available for third years, along with many independent rotations where residents are the sole resident on the service. Residents rotate through endocrine, thoracic, colorectal, trauma, surgical oncology, emergency general surgery nights, vascular surgery, and general surgery at the VA hospital. The PGY-3 learns to lead a team with PGY-5 backup on colorectal and surgical oncology, while also supervising junior night float residents during EGS nights. In thoracic and endocrine rotations, residents work alongside APPs and Fellows.
All rotations last 5-7 weeks. All GI, surgical oncology, and trauma services are covered by a night float resident during the week, making the on-service PGY 3 responsible for on-call duty every other weekend. Call at the Veterans Affairs Hospital consists of home call among the VA staff team.

Fourth Year

The fourth year of clinical training (PGY-4) continues the progressive assumption of greater responsibility, leadership, and decision-making. Fourth-year residents spend much of their time in the operating room, managing increasingly complex cases and leading teams. The PGY-4 serves as the senior resident on trauma days, trauma nights, and minimally invasive surgery (MIS) services. Senior resident duties are shared with a PGY-5 resident in the surgical oncology and colorectal surgery services. Call generally occurs every second or third weekend; during the first part of the year, it is in-house to allow appropriate supervision of interns, then transitions to home call. All rotations last seven or eight weeks. Flexibility is built into the schedule to allow residents to select rotations and electives that align with their future career interests. One to two senior residents are also chosen to serve as Education Chief Resident, coordinating the educational activities of the program with the administrative chiefs. 

Fifth Year

The chief resident year of general surgery training offers increasing responsibility and independence. Residents are expected to lead their service and are responsible for instructing junior residents and medical students. Chief residents rotate on the Trauma and Acute Care Surgery, UAB Highlands General Surgery, Surgical Oncology, Colorectal, and VA general surgery services in 6-8 week blocks; most on-call duties are home calls. All residents complete more than enough indexed cases required for graduation. Each year, two fifth-year residents are selected to serve as administrative chiefs, overseeing the residency program and collaborating closely with the program director and chairman.

Research

In addition to the five years of categorical general surgery training offered at UAB, residents are given the option to complete two years in the clinical or basic science laboratory. Typically this occurs between the second and third year of residency, but this can be adjusted on a case by case basis. Residents have no clinical duties and often moonlight during these years. Research projects are abundant and heavily funded. Some residents elect to earn a Masters of Public Health degree. Research residents work in the labs of dedicated research as well as clinical faculty. Most residents elect to complete their two years of research after the second clinical year. Research is completely optional.

Operative Experience

As of 2023, on average, our residents perform 1,360 procedures during their residency.

To compare with a national average summary, visit the ACGME.

Moonlighting

The UAB General Surgery Residency program allows residents to take advantage of moonlighting opportunities. We comply with the ACGME requirements of moonlighting, which means residents' clinical and educational work hours must be limited to no more than 80 hours per week, averaged over a four-week period, inclusive of all inhouse clinical and educational activities, clinical work done from home, and all moonlighting. Additionally:

• Moonlighting must not interfere with the ability of the resident to achieve the goals and objectives of the educational program, and must not interfere with the resident’s fitness for work nor compromise patient safety.
• Time spent by residents in internal and external moonlighting (as defined in the ACGME Glossary of Terms) must be counted toward the 80-hour maximum weekly limit.
• PGY1 and PGY2 residents and residents with J-1 visas are not permitted to moonlight.