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The Colon and Rectal Surgery Fellowship provides clinical exposure to the full range of disease of the colon, rectum and anus.
The Division of Colon and Rectal Surgery, part of the Department of Surgery at Penn State College of Medicine, has a strong interest in inflammatory bowel disease, and the Inflammatory Bowel Disease Center serves as a regional referral center for all patients with IBD. Furthermore, the division offers state-of-the-art sphincter-preserving surgery for rectal cancer and treatment for complex anorectal disease. Learn more about the clinical team here.
The majority of the abdominal cases are performed with minimally invasive access (standard laparoscopy, single site laparoscopy, robotic surgery) and for selective rectal cases, transanal endoscopic microsurgery (TEMS) or transanal minimally invasive surgery (TAMIS) are used. The expected annual volume for each fellow is approximately 200 to 300 abdominal (60 percent or more are laparoscopic, 10 percent of which are robotic) and 150 to 250 anorectal cases.
The fellow will be exposed to more than 35 robotic cases per year. Transanal endoscopic microsurgery and transanal minimally invasive surgery are routinely performed for rectal polyps or early cancers. The service performs both fiber-optic and rigid proctosigmoidoscopy and colonoscopy. The fellow will have the opportunity to perform 150 to 200 colonoscopies and 100 sigmoidoscopies. Furthermore, the fellow is expected to see approximately 500 new patients in clinic; 35 percent of the cases are IBD, 35 percent colorectal cancer and 30 percent benign diseases (diverticulitis, polyps, anorectal etc.). The program’s goal is to train individuals to become safe, well-rounded specialists in colon and rectal surgery and active members of the American Society of Colorectal Surgery (ASCRS).
Learn More about the Fellowship
The Colon and Rectal Surgery Fellowship uses the Electronic Residency Application Service (ERAS).
Applicants must submit the following through ERAS:
- Application form
- Curriculum vitae
- Three or more letters of recommendation
- Medical school transcript
- USMLE scores for parts I, II and III
- Personal statement
- Medical school dean’s letter
The Colon and Rectal Surgery service is divided into two teams, the blue team and the white team.
The Colon and Rectal Surgery fellow will rotate services every six weeks, alternating with the chief General Surgery resident, giving the Colon and Rectal fellow six months on each service in total. While on each service, the Colon and Rectal Surgery fellow will be responsible for the daily care of their assigned attending’s inpatients, participate in clinic with the assigned attending and assist in the operating room.
There are four General Surgery residents assigned to the service on a rotating basis: a chief resident, a second-year resident and two interns. The General Surgery residents rotate on the Colon and Rectal Surgery service for three months at a time, and will spend six weeks on each rotation.
At no time will both the chief General Surgery resident and the Colon and Rectal Surgery fellow be assigned to the same team. The junior residents on the service (second-year residents and interns) will work with both teams.
Operative cases will be assigned to the chief General Surgery resident and the Colon and Rectal Surgery fellow by service.
Certain “index” cases, such as sphincter reconstruction and resection of presacral tumors, will be assigned to the Colon and Rectal Surgery fellow regardless of the team they are on.
General Rotation Schedule
Sample Weekly Schedules
- Monday: Operating room
- Tuesday: Academic
- Wednesday: Clinic
- Thursday: Operating room
- Friday: Operating room
- Monday: Operating room
- Tuesday: Operating room
- Wednesday: Operating room
- Thursday: Operating room
- Friday: Clinic
There is a full complement of residents and medical students on the Colon and Rectal Surgery service. The Colon and Rectal Surgery fellow will be part of the team and interact with the residents and medical students on a daily basis.
The fellow will be expected to assist in the daily care of patients and teach the junior residents the same. They will also be expected to provide formal and informal teaching sessions to the residents and medical students on the service.
The Colon and Rectal Surgery fellow will have no in-house call responsibilities. They will be expected to share home backup call for the in-house junior residents with the chief General Surgery resident assigned to the service. The fellow will also be expected to alternate weekend call, including patient rounds, with the chief General Surgery resident.
Three weeks of vacation are provided per year, with an additional five days of CME/education time that may be approved at the discretion of the program director.
The Colon and Rectal Surgery service works closely with other services in the hospital, including gynecologic oncology, urology, oncology, radiation oncology and especially gastroenterology. Not only do the services coordinate care of the patients, but there are several interdisciplinary conferences among the groups, such as IBD conference and GI tumor board.
In addition, representatives from many of these services will provide lectures to the Colon and Rectal Surgery fellow.
Through sharing of patients, lectures and conference interactions, Colon and Rectal Surgery fellows will gain a broad multidisciplinary approach to the care of patients. In addition to close interaction with other services in the hospital, the Colon and Rectal Surgery service maintains a close relationship with the enterostomal therapists. Their assistance in taking care of patients with ostomies is invaluable. They regularly attend the division’s preoperative conference so that they can be involved in patient care from the beginning.
In addition to the clinical staff, there is a full-time basic science research staff consisting of one PhD, two postdocs, one resident, one clinical research fellow and three research technicians.
All of these conferences are mandatory for the Colon and Rectal Surgery fellow.
Pre-Operative Case Conference
Every Wednesday, 7 to 8 a.m.
All the operative cases for the following week are discussed, including indications for surgery, workup and pathophysiology. Pertinent studies such as colonoscopies, CT scans, barium studies and pathology will be reviewed.
GI Tumor Board
Last Friday of the month, 7 to 8 a.m.
Interesting/complex patients with GI cancers (primarily colon and rectal cancers) are presented and discussed in a multidisciplinary conference. In attendance are surgeons, gastroenterologists, pathologists, radiologists, oncologists and radiation oncologists. The cases are presented by the Colon and Rectal Surgery fellow and the General Surgery residents.
Inflammatory Disease Center
Every Wednesday, 3 to 4 p.m.
This is an interesting case conference run by the Department of Medicine’s Division of Gastroenterology and Hepatology. At each conference, a surgical case is presented. The fellow will be responsible for half of these presentations; they will also be expected to attend the conference the other weeks when the topic of the case being presented by the GI service is appropriate.
Colon and Rectal Didactic Series
Every Friday, 7 to 8 a.m.
The Colon and Rectal Didactic Conference is designed to cover all aspects of colon and rectal surgery. The Colon and Rectal Surgery fellow and the chief General Surgery resident will be required to give one lecture every three months. Topics will be assigned. There will be lecturers from outside the department to cover the following topics:
- Radiology of the colon and rectum
- CT scans
- Fluoroscopic exams
- Pathology of the colon and rectum
- Cancer and polyps
- IBD and miscellaneous
- GI medicine
- Medical management of IBD
- Medical management of constipation
- Medical treatment of metastatic colorectal cancer
- Radiation for rectal cancer
- Surgical management of liver metastasis
- Anesthesia for colon and rectal surgery
- Aspects of general anesthesia
- Local and regional anesthesia
- Pediatric colon and rectal surgery
- Imperforate anus
- Hirschsprung’s disease
The rest of the conferences will be given by the Colon and Rectal Surgery faculty.
Colon and Rectal Journal Club
Every other month
Colon and Rectal Journal Club will be held four times per year (every other month). Two to four current articles relating to colon and rectal surgery will be discussed. The Colon and Rectal Surgery fellow and the chief General Surgery resident on the service will present the articles.
All of these conferences are mandatory for the Colon and Rectal Surgery fellow unless otherwise stated.
Morbidity and Mortality
Every Wednesday, 5 to 6 p.m.
The Colon and Rectal Surgery fellow will present the morbidities and mortalities from the colon and rectal service at this conference. In addition to providing the details of the case, they will be required to discuss the teaching points and present a pertinent literature review.
Every Thursday, 5 to 6 p.m.
One Thursday a month, 7 to 9 a.m.
This program is required only when the subject material is appropriate to Colon and Rectal Surgery. Optional for other topics.
These conferences are organized by the Office of Graduate Medical Education. Learn more about these lectures here.
Colon and Rectal Lab Meeting
Every Friday, 9 to 10 a.m.
Ongoing basic science research projects in the Colon and Rectal Lab are discussed.
Surgical Research Seminar
Every Wednesday, noon to 1 p.m.
Research being performed in the Department of Surgery is presented.
Fellow Honors and Recognitions
The annual Resident/Fellow Research Day is held each summer on and around the Penn State Health Milton S. Medical Center campus in Hershey, PA.
The intent of the event is to provide an opportunity for residents and fellows to showcase their research accomplishments to their peers in other clinical departments, as well as their colleagues in the basic sciences.
Previous presentations from the Colon and Rectal Surgery Fellowship are listed here.