Fellowship
Colon and Rectal Surgery
The Colon and Rectal Surgery Fellowship at Penn State Health Milton S. Hershey Medical Center is a one-year, ACGME-accredited program that admits one fellow per year.
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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.
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.
Program Overview
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
Photograph
Contact and Leadership
Program Coordinator, Colon and Rectal Surgery Fellowship, Surgery
Mailing Address
Penn State Health Milton S. Hershey Medical Center
Division of Colon and Rectal Surgery
500 University Dr.
P.O. Box 850
Hershey, PA 17033
General Contact Information
Phone: 717-531-5164
Fax: 717-531-0646
Supporting Your Training
Curriculum Details
Rotations
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.
Sample Weekly Schedules
Blue rotation
Monday: Operating room
Tuesday: Academic
Wednesday: Clinic
Thursday: Operating room
Friday: Operating room
White rotation
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
Every Friday, 7 to 8 a.m. via Microsoft Teams. 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.
Colon and Rectal Didactic Series
Every Tuesday, 6:30 to 7:30 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
Oncology
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.
All of these conferences are mandatory for the Colon and Rectal Surgery fellow unless otherwise stated.
Morbidity and Mortality
Every Thursday, 7 to 8 a.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.
Grand Rounds
Every Thursday, 5 to 6 p.m.
Core Competencies
Monthly
These conferences are organized by the Office of Graduate Medical Education.
Fellow Honors and Recognitions
The annual Resident/Fellow Research Day is held each year (with exception of during the COVID-19 pandemic) on and around the Penn State Health Milton S. Hershey Medical Center campus.
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.
Learn more about Resident/Fellow Research Day here.
Previous presentations from the Colon and Rectal Surgery Fellowship are listed here.
