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Washington University School of Medicine in St. Louis/Barnes Jewish Hospital/St. Louis Children's Hospital

Washington University School of Medicine in St. Louis/Barnes Jewish Hospital/St. Louis Children's Hospital | ASCRS

Program Director: 
Steven Hunt, MD
Washington University Scholl of Medicine in St. Louis/Barnes Jewish Hospital/St. Louis Children's Hospital
Campus Box 8109, 660 South Euclid Avenue
Suite 14102 Queeny Tower
St. Louis, MO 63110
United States
(314) 454-7177
(314) 454-5249

Program Coordinator:  Emily Stroisch


Number or Residents (per year): 

Number of Faculty (ABCRS Certified): 6 

Salary/Year: $65,370 

University Affiliation: Washington University (St. Louis, MO) 

Case Mix/Number of Cases: During the yearlong fellowship, residents will have an extensive experience in advanced minimally invasive approaches such as laparoscopy, robot-assisted and TEM procedures. Each fellow (on average) does 260 abdominal/pelvic resections, 130 anorectal cases and 175 colonoscopies. 

Strengths of Program: The University based program is integrated into the general surgery residency program, providing an excellent learning environment and teaching experience for the colorectal resident. The clinical practices of the each faculty member is broad based includes high volume anorectal cases, inflammatory bowel disease, colon cancer, rectal cancer, functional colon disorders, laparoscopy, TEM and colonoscopy.  There is broad support from clinical sciences and basic research. Specific interests include radiation therapy for rectal cancer, as adjuvant treatment and also as primary therapy using endocavitary radiation for selected cases. The residents rotate at Barnes-Jewish Hospital, which is a large tertiary academic center and Barnes-Jewish West County Hospital, a smaller community based facility. 

Clinical Rotations: Residents alternate with a senior resident (PGY 5) through four clinical rotations in one-month blocks at two separate medical facilities: Barnes-Jewish Hospital and Barnes-Jewish West County Hospital. The Barnes-Jewish main campus rotations are supported with a consult resident (PGY 3), two interns and physician extender. The focuses of these rotations are extensive operative and inpatient experiences. Barnes-Jewish Hospital is a tertiary medical center so there is ample exposure to "bread and butter" — as well as diverse and complex — colorectal surgery. The two Barnes-Jewish West County Hospital rotations are also supported by a junior general surgery resident, an intern and a nurse practitioner. Additionally, there is in house coverage by a junior general surgery resident at night and during weekends. One rotation is an inpatient rotation that focuses on the operative and inpatient experiences. The second rotation is an outpatient experience that focuses on outpatient clinic evaluations, colonoscopy, anal physiology and surgical management. On this rotation, residents gain extensive knowledge of endoscopy, anorectal manometry and transrectal ultrasonography. 

Interaction with General Surgery Residents: The colon and rectal surgery resident functions closely with junior surgical house staff, supervising patient evaluations and hospital care. He/she attends general surgical conferences and participates when appropriate.  As mentioned, there are two inpatient services at Barnes-Jewish. The fellow and chief resident is responsible for the services with no overlap in patient care or operative cases. There is a third year resident on the service that is responsible for inpatient consults and manages the ICU patients. There are two interns on the floor so that each service has an intern during the year. 

Conferences: The resident is directly responsible for organizing and conducting the weekly colorectal multidisciplinary conference, a working conference in which a wide variety of current clinical cases are discussed. The conference is attended by colorectal faculty, gastroenterologists, pathologists, radiation oncologists, medical oncologists, medical students and general surgical house staff. He/she also attends general surgery grand rounds, general surgery conference, and gastroenterology conference, and participates in the monthly surgery journal club. There is a weekly didactic lecture and every other week there is a pelvic floor abnormality conference that is required. 

Anorectal Physiology: Defecography, anal manometry, pudendal nerve conduction studies and endorectal ultrasound are all routinely performed. The resident will be responsible for the performance interpretation of the physiology lab testing with supervision by an attending. 

Outside Rotations: None are offered. 

Research Year: A research year is available. 

Requirement for Paper: A paper is required for completion of the program. Clinical research is strongly promoted and the resident is encouraged to submit such research for presentation at the ASCRS Annual Scientific Meeting. 

Opportunity to Attend Meetings: One meeting of the residents’ choice is provided each year. Support is also provided to attend appropriate scientific meetings at which the resident presents original research material. 

Training Courses: The fellows are sent to a robotic training course as well as a career/laparoscopic course. All travel expenses are covered.