Performance Evaluation
Established means by which each resident's performance is assessed by faculty members and chief residents include:

1. Clinical Evaluation -- Residents are evaluated at the end of each of their service rotations by faculty and, when appropriate, chief residents. The completed evaluation forms, which include specific objective and subjective evaluation items, are reviewed by the program director and placed in the resident's file.
2. Resident Advisory Committee -- Discussions about resident performance occur annually, and on an as-needed basis.
3. Letters from faculty members regarding resident performance are forwarded to the program director and are included in the resident's file.
4. Mock Oral Exam Evaluation -- Faculty and senior residents participate in a formal session aimed at evaluating junior and senior resident performance on the mock oral exam.
5. American Board of Surgery In-Service Training Exam -- Residents are required to take this exam and score at or above the 25th percentile.
6. Academic Conference Attendance -- Residents are required to maintain at least 50 percent attendance level at each of the following conferences: basic science lecture, grand rounds and morbidity and mortality conference.
7. Teaching evaluations - Residents are expected to assume a positive and effective teaching role on morning rounds, in the operating room, on call and in a classroom.
8. Prior to graduation, residents must prepare and submit for publication a manuscript on a clinical or basic science topic.
9. Residents must pass the USMLE Step III to be promoted to their fourth year.

The educational specialist meets with each resident during the fall to assess progress and set performance goals for the academic year. The program director meets with each resident during the spring to assess progress and discuss promotion and retention decisions made in concert with the Resident Advisory Committee. Furthermore, residents are provided the opportunity to review their files in the presence of a faculty member throughout the year.

Promotion
The Department of General Surgery will annually review the clinical and academic performance and progress of each resident in order to determine their suitability for promotion or graduation. The measures that the department uses for resident evaluation are as follows:

• First, patient care and management on each rotation as documented by the faculty survey forms. The resident should ideally go over these with each attending they work with to receive timely feedback on their performance. Major performance deficits will be grounds for probation, repeat of the service or year or dismissal.
• Second, attendance at academic conferences (morbidity and mortality, grand rounds, and basic science lectures) is mandatory for residents. Failure to attend more than half of any of these conferences will be grounds for probation.
• Third, residents are expected to pass an annual oral examination. Failure to pass the oral exam for two successive years will be grounds for probation. Failure to complete a scheduled oral exam or make-up exam within an academic year without an approved excuse will be considered a failing grade. Residents who fail the oral exam may elect to re-take the exam on the scheduled make-up day within that academic year. Successful completion of the make-up exam will be a recognized pass for that academic year. If a resident does not retake the make-up oral exam or fails the make-up oral exam, it will count as a fail for that academic year. If a resident misses the scheduled date, and fails the make-up exam, it counts as a fail for that academic year and no additional testing will be offered.
• Fourth, residents must take the American Board of Surgery In-Training Exam (ABSITE) annually. Failure to score above the 25th percentile will be grounds for probation.
• Fifth, residents are expected to contribute to the academic and scholarly mission of the department. This will be evaluated by student and resident teaching and overall faculty assessment surveys.
• Sixth, residents must comply with all hospital and departmental record-keeping and documentation requirements. This includes timely submission of operative case lists (surgical operative logs) and morbidity and mortality reports. A pattern of lateness and non-compliance will be grounds for probation. When a resident is placed on probation a remedial program will be instituted to correct the particular deficits. Failure to meet departmental standards in these areas when a resident has been placed on probation will result in either their expulsion from the program or their having to repeat the year of training at the same level. If a year of residency is repeated, the resident will be expelled if departmental standards are not met in that year.

Residency training in surgery is a full-time responsibility; activities outside the educational program must not interfere with the resident's performance in the educational process, as determined by the program director, nor must they interfere with the residents' opportunities for rest, relaxation, and study.