On-call Requirements and Vacation Time
All residents are given equivalent rotations and experience almost identical clinical exposure throughout the year. In general, residents are on call at Yale-New Haven Hospital once every four nights and at the chief resident level may take call from home approximately once every four nights. The mandated 80-hour workweek is strictly adhered to, as averaged over 4 week periods. At least one day each week is free of all clinical responsibilities.
Residents are given three weeks of vacation each year with some added time for senior residents to attend a review course. This is in addition to time allotted to present research at meetings. Time and funding are arranged for all residents to attend basic trauma courses.
Program and Resident Evaluations
The residency program is continually evaluated by several means. The program director and the resident education committee (one resident from each year) meet at least quarterly and on an ad hoc basis if needed to critique, discuss, and improve the effectiveness of the resident education program. Twice each year each resident evaluates the rotations specifically and the program as a whole and provides this information anonymously to the faculty. The entire faculty assesses the educational aspects of the program at semi-annual meetings.
The faculty evaluates individual resident performance after each rotation and twice a year a summary is generated at a faculty meeting. Twice during each rotation, each resident's technical surgical skills are assessed by the appropriate faculty member. This information is shared with each resident confidentially by his/her advisor. Conversely, semi-annually each resident evaluates each faculty member with whom he/she has worked, again on an anonymous basis. This information is confidentially communicated directly to the involved individuals. In accordance with the six competencies, each resident's professionalism and communication skills are also evaluated semi-annually by the nursing staff on the wards and in the clinics and by the office staff.
Research has been a long-standing strength of Yale University and of each department. The medical school requires each student to produce a thesis in partial requirement for their graduation, and this value is consistent with each department's emphasis on scholarly activity as well. In order to accomplish this mission, our department provides substantial financial investments.
This supports a core histology laboratory, photographic services, computers and library facilities which are available regularly to all residents. Up to 8 months of protected research time is available during the final four years of the residency. Residents are assigned a research advisor and are exposed to faculty research interests through departmental publications and organized "research-in-progress" sessions given by senior residents and clinical and Full-time Research Faculty members.
Residents are encouraged to apply for pilot funding through the department for their research projects. Projects are assessed and critiqued at a research forum held annually. Funds are allocated to support resident travel for educational courses and for presentation of research at national meetings.
Legal Medicine, Medical Ethics, Economics of Healthcare
Legal medicine and medical ethics are taught in yearly programs by staff from the risk management section of Yale-New Haven Hospital and ethicists from the Yale University School of Medicine as part of our core curriculum. Discussions regarding ethics are encouraged and integrated informally through faculty/resident interactions on an almost daily basis.
Health economics and cost containment are addressed in our core curriculum series by visiting speakers. These conferences traditionally generate substantial discussion and provide residents with new insights for the practice of cost effective quality care. In addition, the hospital is developing a generic program in ethics and medicolegal issues.