Rotations and Curriculum

Facilities

• Robotic trainer
• Anatomy lab

Rotation schedule

While rotations are primarily at the St. Elizabeth Youngstown Hospital campus, other rotation sites include:

• St. Elizabeth Boardman Hospital
• St. Joseph Warren Hospital
• Akron Children’s Hospital
• University Hospitals

Didactic Curriculum

Skills and Simulation Lab

• Faculty and chief resident mentored
• Dedicated curriculum based on ACS/APDS Surgery Resident Skills Curriculum
• Includes bedside, open, laparoscopic, robotic and endoscopic procedures
• VR endoscopic trainer (same is used for SAGES FES Exam required for ABS certification)
• VR laparoscopic trainer
• VR robotic surgery trainer
• 24/7 access
• Objective assessments completed to measure personal progress

Experimental Surgery Course

• Six-week course at start of PGY-1
• Four-hour sessions of immersive training in basic surgical techniques
• Faculty facilitated
• Offsite location

Surgical Morbidity and Mortality Conference

• Resident led; faculty mentored
• Formal presentations prepared
• Brief literature review relevant to cases

Surgical Principles Conference

• Resident led; faculty mentored
• Based on national SCORE curriculum
• Assigned textbook reading assignments based on weekly topic

Trauma Conference

• Resident led; faculty mentored
• Interesting trauma cases presented
• Practice Management Guidelines discussed

Tumor Board, Breast Conference, Hepatobiliary Conferences

• Multidisciplinary presentation and review of newly diagnosed cancers
• Further evaluation and management plans developed in real time
• Led by attending oncologist, breast surgeon or HPB surgeon
• Residents attend

Mock Oral Exam

• SCORE-based content/scenarios
• One-on-one live practice oral exam between local faculty and senior resident
• Faculty score and provide feedback and critique of resident performance
• Graduates complete training with eight to 12 exams

Journal Club

• Resident led; faculty mentored
• Formal presentation of high impact journal articles
• Critique of study design, outcomes, analysis and conclusions

Surgical Anatomy Lab

• Resident led; faculty mentored
• Eight to nine annual sessions
• Onsite, cadaver-based review of relevant surgical anatomy

Research and Scholarly Activity

• Opportunity for research: The trauma department has a dedicated research group with nurses and statisticians available to assist in implementation, publication and presentation of trauma-related research. Participation in research is primarily resident-lead; however, we have recently increased structure and mentorship to help facilitate early start and completion of research projects. Many faculty members have research ideas of their own and would love resident partnership to implement them. Our program does not have a dedicated research year or month and does not have a basic science lab for research. However, given our largely unopposed program, case studies and retrospective studies have been presented both locally and as far away as Hawaii. Presentations are completely supported by the program with finances and time, with no cut to your vacation allowance.
• Opportunity for elective rotations, including mission work: Our program has one month available for an elective rotation in your fourth year. Early coordination is encouraged. Historically, this has not been abroad due to need for call coverage, however with the recent increase in size to our program, this can be discussed.
• Mission/Rural Surgery Tract: With ENT and orthopedics being the only other surgical subspecialties at this Level I trauma center hospital, this residency is ideal for mission or rural surgery tract. If interested, residents may scrub with urology and our OB/GYN physicians. The ENT and orthopedic residents are happy to include general surgery residents, even walking us through their routine thyroidectomies and parathyroidectomies.

Publications and Presentations

Peer Reviewed Published Studies

1. Dunham CM, Malik RJ, Huang GS, Kohli CM, Brocker BP, Ugokwe KT. Hypertonic saline administration and complex traumatic brain injury outcomes: a retrospective study. Int J Burn Trauma. 2018;8(3):40-53. PMID: 30042863. (Critical Care, Resident, Neurosurgery, Trauma)
2. Dunham CM, Berger A, Hileman BM, Chance EA. Learning receptive awareness via neurofeedback in stressed healthcare providers: a prospective pilot investigation. BMC Research Notes. 2018 Sep 4;11(1):645. PMID: 30180909. (Trauma)
3. Abdel Aziz H, Dunham CM. Effectiveness of computed tomography scanning to detect blunt bowel and mesenteric injuries requiring surgical intervention: A systematic literature review. Am J Surg. 2018 Aug 30. PMID: 30201138. Epub ahead of print. Accessed 13 September 2018. https://www.sciencedirect.com/science/article/pii/S0002961018301235?via%3Dihub. (Trauma)
4. Abdel Aziz H. Hileman BM, Chance EA. No correlation between lower extremity deep vein thrombosis and pulmonary embolism proportions in trauma: a systematic literature review. Eur J Trauma Emerg Surg. 2018;44:843-850. PMID: 30382316. (Trauma)
5. Mann N, Welch K, Martin A, Subichin M, Wietecha K, Birmingham LE, Marchand TD, George RL. Delayed intracranial hemorrhage in elderly anticoagulated patients sustaining a minor fall. BMC Emerg Med. 2018 Aug 24;18(1):27. PMID: 30142999. (Trauma)
6. McDonald AA, Robinson BRH, Alarcon L, Bosarge PL, Dorion H, Haut ER, Juern J, Madbak F, Reddy S, Weiss P, Como JJ. Evaluation and management of traumatic diaphragmatic injuries: A Practice Management Guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2018 Jul;85(1):198-207. PMID: 29613959. (Trauma)
7. Dunham CM, Burger AL, Hileman BM, Chance EA. Psychometric properties of the St. Elizabeth Youngstown Hospital Wellbeing Inventory and Non-Burnout Inventory for physicians and nurses. Submitted BMC Psychology. 2019 Jun 17;7(1):36. PMID: 31208464. (Trauma)

Trauma System Operations Committee (TSOC)
2019 – 2022 Review, Trauma Research Report

Peer Reviewed Published Studies

1. Dunham CM, Burger AL, Hileman BM, Chance EA, Hutchinson AE, Kohli CM, DeNiro L, Gifford JM, Lisko P. Brainwave Self-Regulation during Bispectral Index™ Neurofeedback in Trauma Center Nurses and Physicians after Receiving Mindfulness Instructions. Frontiers in Psychology. 2019;10:2153. PMID: 31616348. (Trauma, Anesthesiology, Neurosurgery, Nursing)

2. Walsh DS, Gantt NL, Irish W, Sanfey HA, Stein SL. Policies and practice regarding pregnancy and maternity leave: An international survey. Am J Surg. 2019 Oct;218(4):798-802. PMID: 31395271. (Surgery)

3. Huang GS, Dunham CM, Chance EA, Hileman BM. Detecting delayed intracranial hemorrhage with repeat head imaging in trauma patients on antithrombotics with no hemorrhage on the initial image: A retrospective chart review and meta-analysis. Am J Surg. 2020 Jul;220(1):55-61. PMID: 31619376 (Trauma, Critical Care)

4. Kight CE, Bouche JM, Curry A, Frankenfield D, Good K, Guenter P, Murphy B, Papoutsakis C, Richards EB, Vanek VW, Wilk D, Wootton A.  Consensus Recommendations for Optimizing Electronic Health Records for Nutrition Care. Nutr Clin Pract. 2020 Feb;35(1):12-23. PMID: 31674077. (Critical Care)

5. Bingmer K, Walsh DS, Gantt NL, Sanfey HA, Stein SL. Surgeon Experience with Parental Leave Policies Varies Based on Practice Setting. World J Surg. 2020 Jul;44(7):2144-2161. PMID: 32133569. (Surgery)

6. Pollack CV Jr, Peacock WF, Bernstein RA, Clark CL, Douketis J, Fermann GJ, Fiore GJ, Frost A, Jahromi B, Johnson C, Merli G, Silber S, Villines TC, Fanikos J, Hospital Quality Foundation (SEYH site PI Gruber BS). The safety of oral anticoagulants registry (SOAR): A national, ED-based study of the evaluation and management of bleeding and bleeding concerns due to the use of oral anticoagulants. Am J Emerg Med. 2020 Jun;38(6):1163-1170. PMID: 32014375. (Trauma)

7. Konik RK, Huang GS. Management of Primary Necrotizing Fasciitis of the Breast: A Systematic Review. Plastic Surgery. 2020 Jun 4; (Surgery)

8. Bulger EM, May AK, Robinson BRH, Evans DC, Henry S, Green JM, Toschlog E, Sperry JL, Fagenholz Pm Martin ND, Dankner WM, Maislin G, Wilfret Dm Bernard ACm ACCUTE Study Investigators (includes: Huang GS, Gruber BS, Dorion HA, Ransom KJ, Rhodes RA, Mount MG, Marchand TD). A Novel Immune Modulator for Patients With Necrotizing Soft Tissue Infections (NSTI). Ann Surg. 2020 Jul 8. Online ahead of print https://pubmed.ncbi.nlm.nih.gov/32657946/. Accessed 9/1/2020. PMID: 32657946. (Surgery, Critical Care, Trauma)

9. Niederman MS, Alder J, Bassetti M, Boateng F, Cao B, Corkery K, Dhand R, Kaye KS, Lawatscheck R, McLeroth P, Nicolau DP, Wang C, Wood CG, Wunderink RG, Chastre J. Inhaled amikacin adjunctive to intravenous standard-of-care antibiotics in mechanically ventilated patients with Gram-negative pneumonia (INHALE) (SEYH investigators: Ransom KJ, Gruber BS, Dorion HA, Rhodes RA, Huang GS, Mount MG): a double-blind, randomized, placebo-controlled, phase 3, superiority trial. Lancet Infect Dis. 2020 Mar;20(3):330-340. PMID: 31866328. (Critical Care, Trauma, Surgery)

10. Wallace J, Huang GS, Hileman BM. Examining Racial Disparities in Adolescents seen at the Emergency Department for Head, Neck, or Brain Injury. J Emerg Med. 2020 Sep 4;S0736-4679(20)30683-1. Epub ahead of print. Accessed 9/10/2020. https://www.sciencedirect.com/science/article/abs/pii/S0736467920306831. PMID: 32893067. (Trauma)

11. Huang GS, Dunham CM, Chance EA, Hileman BM, DelloStritto DJ. Body mass index interaction effects with hyperglycemia and hypocholesterolemia modify blunt traumatic brain injury outcomes: a retrospective study. International Journal of Burns and Trauma. 2020 Dec 15;10(6):314-323. eCollection 2020. PMID: 33500843. (Trauma, Critical Care)

12. Beyene RT, Derryberry SL. The Effect of Comorbidities on Wound Healing. Surg Clin North Am. 2020 Aug;100(4):695-705. PMID: 32681870. (Surgery)

13. Shah S, Derryberry S, Teman N, Tribble C. What Happens in (the) Vagus, Stays in (the) Vagus. Heart Surg Forum. 2020 May 22;23(3):E335-E342. PMID: 32524966. (Surgery)

14. Tribble C, Merrill W, Derryberry S, Parrino G. The Median Sternotomy: The Unkindest Cut of All? Pearls, Pitfalls, Aphorisms, & Myths. Heart Surg Forum. 2021 Mar 25;24(2):E267-E277. PMID: 33798038. (Surgery)

15. Dunham CM, Burger AJ, Hileman BM, Chance EA, Hutchinson AE. Bispectral Index Alterations and Associations with Autonomic Changes During Hypnosis in Trauma Center Researchers: Formative Evaluation Study. JMIR For Res. 2021 May 26;5(5):e24044. PMID : 34037529. (Critical Care, Anesthesiology)

16. Huang GS, Chance EA, Dunham CM. Influence of a stay-at-home order on trauma volume and injury patterns at a level I trauma center in Ohio. The American Surgeon. 2021;Nov 3: 31348211047488. Epub ahead of print accessed 11/4/2021. (https://journals.sagepub.com/doi/pdf/10.1177/00031348211047488) PMID: 34732068. (Trauma)

17. Dunham CM, Burger AL, Hileman BM, Chance EA, Hutchinson AE, Kohli CM, Lisko P. Effect of contemplating patient care spiritual flow principles and mindfulness on trauma center nurses’ wellbeing: a pilot study. Int J Burns and Trauma. 2021 Dec 15;11(6):477-485. PMID: 35111383. (Trauma, Anesthesiology, Neurosurgery).

18. Dunham CM, Marchand TD, Chance EA, Hileman BM. Hyperadrenergic Risk Conditions Increase the Probability for Trauma Center Alcohol Withdrawal Syndrome. Injury. Submitted. (Trauma, Critical Care)

19. Chirichella TJ, Han JS, Dunham CM, Renner CE, Neubauer SA, McCarron NF. Establishing an open and robotic pancreatic surgery program in a level 1 trauma center community teaching hospital and comparing its outcomes to high-volume academic center outcomes. BMC Surgery. Submitted 10/20/2021. (Surgery, Resident).

20. Dunham CM, Huang GS, Chance EA, Hileman BM. Trauma center risk conditions for blood alcohol-positive and alcohol misuse patients: A retrospective study. International Journal of Burns and Trauma. Accepted 2022-08-15.