Garth Jacobsen, MD: A General Surgery Residency That's "Second-to-None

As Director of our General Surgery Residency, Garth Jacobsen, MD, is committed to educating surgeons of the future. The UC San Diego General Surgery Residency Program provides a comprehensive training program encompassing the spectrum of core general surgery and general surgery subspecialties, including cardiothoracic, transplant, oncology, vascular, colorectal, trauma, and pediatric surgery. Here Dr. Jacobsen describes the program in more detail.

Q: What are the highlights of our General Surgery residency program?
A: At its core, the UCSD general surgery residency represents a robust collaboration between a dynamic academic faculty and some of the brightest and most talented trainees in the country. This collaboration, in combination with a strong culture of wellness and continuous improvement, allows us to produce an outstanding future generation of surgeons. This partnership takes place in an environment which is second to none, facilitating this partnership and the growth of our trainees. The clinical milieu is robust and varied ranging from the hyperacute care environment at Hillcrest hospital, the highly specialized services on the La Jolla campus, the busy Veterans hospital, and exposure to pediatric and managed care services at Rady’s children’s hospital and the Kaiser healthcare system.

Q: What does the curriculum entail and how long is the program?
A: The curriculum consists of clinical rotations at each of those sites.Graduated responsibility is the rule, progressing to autonomy during the Chief resident year. The busy clinical training environment is supported by a framework of academic conferences that take place within the clinical rotations, and a weekly education conference involving Mock oral exams, quality improvement, grand rounds, and a surgical education curriculum, followed by a surgical simulation session. The program is 5 years in total, but most residents take advantage of a two-year research fellowship resulting in an average total time of 7 years.

Q: What would you say sets this program apart from others of its kind?
A: I think the culture and clinical training environment are enough to give UC San Diego the edge relative to most training programs in the country. However, during interview time with potential candidates I always take time to speak about two additional strengths of the program. The first is the simulation center at the Center for the Future of Surgery, led by Dr. Horgan with a curriculum administered by Drs Sandler and Broderick. Residents begin their academic life with a surgical boot camp, and progress through a weekly simulation curriculum involving animate, high, and low fidelity models. I firmly believe this early simulation exposure results in senior residents who are technically superior to their peers in other programs. The second additional strength is access to robust research fellowships. Residents are encouraged as early as the interview process to start thinking about areas of academic interest. Trainees are guided towards career enriching fellowships that range from our own T32 training programs and faculty sponsored labs to outside the box experiences of their own choosing. This results in an outstanding fellowship match rate with most trainees obtaining their first choice in fellowships.

Q: What kind of residents are you looking for?
A: There is no one type of individual we are looking for, in fact we are very interested in recruiting a diverse collection of trainees with varied backgrounds and strong ideals. However, there are some essential traits we do look for. We look for individuals with integrity, without this it is impossible to train a strong surgeon. In addition, our training environment also hinges on teamwork, so we look for those with a history of being a great team player. A personal framework of continuous improvement also is essential trait in a candidate looking to train at UC San Diego. We are also looking for those that are academically curious and have a track record of documented investigation into those curiosities. Finally, we are looking for trainees who want to be in our program and contribute to the overall culture.

Q: What are some of the challenges of running the program?
A: I recognized extremely early on that running this program was not a one-person job. I find that any of the challenges we face are best managed with a team approach. We have outstanding teams that work to either immediately solve, or if not possible incrementally improve upon the situation. This starts having an excellent program coordinator, Lupita Nuno, who keeps track of the administrative framework and programmatic requirements. In addition, each year we also select three administrative Chief Residents who serve as the leadership for the resident physician council. This collaboration meets monthly in an effort to fine tune the program. Finally, the leadership and support of the chair's office and Dr. Clary, as well as my associate program directors Berumen (wellness), Berndtson (curricula), and Sicklick (research) are critical to solving any problem that may arise.

Q: What motivates you to keep running the program from year to year?
A: This is an easy one. It’s the trainees. Each year we start with a list of approximately 1500 applicants for our 7 residency slots. I have now been fortunate enough to see some of these individuals start on paper as an applicant, and finish as accomplished faculty members either at UCSD or elsewhere. I enjoy sharing with them the excitement of matching into our program and watching them grow through the challenges of their junior years. It is rewarding to watch them progress academically during their research fellowships and come back to accelerate through their senior years culminating into getting great jobs or matching into outstanding fellowships. I can't wait to celebrate these accomplishments of our current chief resident class, this year with pomp and circumstance, in person!;