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Lahey Hospital and Medical Center

Lahey Hospital and Medical Center | ASCRS

Program Director: 
Elizabeth Breen, MD
Address: 
Lahey Hospital and Medical Center
41 Mall Road
Burlington, MA 01805
United States
Phone: 
(781) 744-8940
Fax: 
(781) 744-8080

Number of Residents (per year): 2 

Number of Faculty (ABCRS Certified):

Salary/Year: $72,833.00 

Case Mix/Number of Cases: Each resident performs an average of 375 operative cases per year of which 65% are abdominal procedures and 35% are anorectal procedures. Residents also perform an average of 350 flexible endoscopic procedures. 

Strengths of Program: The program is well-balanced providing in-depth exposure to the spectrum of colorectal disorders. Lahey is a tertiary/quartenary referral center for the treatment of patients with rectal cancer, inflammatory bowel disease, diverticulitis and complications following colorectal procedures. There is a substantial volume of reoperative pelvic surgery. Residents also receive in-depth training in the management of routine and complex anorectal disorders, and the management of acute colorectal problems. We are actively involved in the application of laparoscopic and robotic technology to colorectal surgery, minimally invasive approaches to rectal neoplasia [transanal endoscopic microsurgery (TEMS), transanal minimally invasive surgery (TAMIS) and transanal total mesorectal excision (taTME), and advanced endoscopic procedures [endoscopic submucosal dissection (ESD), laparoscopic-endoscopic excision of neoplasms]. We have several state-of-the-art operating rooms devoted to advanced laparoscopic gastrointestinal surgery, complete with fiber-optic carbon dioxide colonoscopy. We are experienced in performing sacral nerve stimulation (SNS) for fecal incontinence. 

Clinic and/or Office Experience: Each resident rotates twice for two months on each of the three clinical services, which each have two to three faculty. During each rotation, residents actively participate in the care of patients in the outpatient and inpatient settings, in the operating room, and in the endoscopy suite. The outpatient clinic, endoscopy suites, inpatient care area and operating rooms are all in the same building, which facilitates resident participation in all aspects of patient care. 

Interaction with General Surgery Residents: Lahey has a free-standing general surgical residency program, and two PGY 1 general surgery residents rotate on the colorectal surgery service.  In addition, a PGY 4 or PGY 5 general surgery resident functions as the chief of one of the three clinical services. At times, a junior resident (PGY 2 or PGY 3) may also rotate on the service. A full complement of general surgery residents (PGY 1, PGY 2/3, PGY 4/5) take in house call and are responsible for inpatient care and emergencies after normal business hours, with the colorectal surgery residents on “back up call”. Only in extremely rare circumstances are the colorectal surgery residents called in after they have left the hospital for the day.

Call Schedule: 

  • 1 in 3 Monday-Friday during normal business hours covering inpatient, emergency room consults and occasional patient telephone calls.
  • 1 in 2 weekends rounding on the inpatient colorectal surgery service.
  • Outside of these responsibilities, the in-hospital team of general surgery residents and faculty cover emergencies, consults, operative cases and telephone calls.

Conferences:

  • Colorectal Lecture Series: core didactic/interactive lecture series. Includes lectures from core faculty, and select lecturers from other specialties within Lahey Health and outside institutions.
  • Teleconference: case management conference with other colorectal surgery groups in New England with cases presented by residents, includes radiology and pathology. This conference was established to create a multi-institutional and collaborative approach to learning. The conference is hosted using web-based, GoToMeeting, software, which allows multiple other sites to participate. We have utilized this forum to give didactic lectures and also case presentations with discussion.
  • Colorectal M & M's: morbidity and mortality conference, cases presented by residents, includes radiology.
  • Journal Club: critical review of manuscripts.
  • Gastroenterology-Colorectal Surgery Conference: lecture and case presentations focused on inflammatory bowel disease and other disorders by residents, in conjunction with faculty from both departments. 
  • Colorectal Multidisciplinary Tumor Conference (MDT): case presentations in conjuction with Medical Oncology; Radiation Oncology, includes radiology and pathology.
  • Research conference: review ongoing research strategies and projects. 
  • GI Radiology Conference: Case presentations by residents and faculty, with critical review of radiographic images, by the departments of colon and rectal surgery, general surgery, gastroenterology and dedicated radiology faculty. 
  • Combined M & M's: Division of Surgery (general surgery, colon and rectal surgery, vascular surgery, hepatobiliary/transplant surgery) morbidity and mortality conference, cases presented by residents, includes radiology.
  • Core Competency Lecture (Residents): coordinated through GME office.
  • Surgical Grand Rounds: coordinated by general surgery faculty; includes visiting professors for Colon and Rectal Surgery (2x/year). 

Outside Rotations: None are offered. Residents participate in anorectal physiology testing at an off-site facility. 

Requirement for Paper: All residents are required to submit an abstract for presentation at the annual meeting of the ASCRS. Residents are encouraged to pursue additional clinical projects that would be anticipated to result in submission of a manuscript for publication. 

Opportunity to Attend Meetings: 

  • Residents are supported to attend the annual meeting of the American Society of Colon & Rectal Surgeons as well as the meeting of the New England Society of Colon and Rectal Surgery, both in the spring. 
  • Attendance at other national or regional meetings is supported if residents are presenting Lahey Clinic data. 
  • Residents are supported to attend one colorectal meeting (including the endorectal ultrasound course) offered by the University of Minnesota or Cleveland Clinic Florida.