During the initial year of residency, you spend your time at Carilion Roanoke Memorial Hospital  (CRMH), assigned to the General Surgery, Colorectal Surgery, Vascular Surgery, Trauma/Acute Care Surgery, ICU and night float services. Additional experiences in Anesthesiology and Emergency Medicine round out the year.
Each resident will function in the role of junior resident on one of the General Surgery services, Breast Care Service, the Acute Care Surgery service, and the ICU service. The remaining time is shared between surgical endoscopy and the breast care services. All rotations are at CRMH except the Endoscopy rotation, which is delivered at our outpatient facility, Carilion Roanoke Community Hospital  (CRCH), located right up the road from CRMH.
During this critically important 'turning point' year you will get your first real taste of senior level responsibility at CRMH, under supervision of dedicated attending staff members, as the chief of the trauma/general surgery ICU service-under which you will have a cadre of junior level house officers to hone your teaching skills. In addition, the Pediatric and Thoracic Surgery services are yours to manage. You will spend time in the more traditional role of junior level resident on one of the larger General Surgery group practices at CRMH. Your American Board of Surgery requirement in Transplantation experience is fulfilled at the University of Virginia.
To provide you with the opportunity to assume the full mantle of a senior level house officer, a blend of rotations is available. For about one half of the year, you will interchange roles with another of your colleagues as the senior most resident on the CRMH trauma service, and as the chief resident on the CRMH night float service, responsible for managing the acutely ill (trauma and general surgery) patient consults. You will of course have the immediate support of dedicated faculty trauma/acute care surgeons who take in-hospital call with you on a rotating 24 hour basis. During the remaining time, you will be mentored in the ways of community surgical practice as the senior-most resident on the Vascular Surgery service and on the General Surgery service at the Carilion New River Valley Hospital-- located just outside Blacksburg, Virginia (home of Virginia Tech University). Finally, you will be reintroduced to cutting edge innovation on the Breast Care Service.
This final year of training exposes the house officers to the complexities of surgical decision-making in several venues, all of which are within CRMH. Rotations on General Surgery, Vascular Surgery and Colorectal Surgery Services are intersperced among your rotations on the resident run Acute Care Surgery Service.
As one should expect from any resident training program, all AGGME-established guidelines for work hours are readily met. The remaining rotations have a frequency of in-hospital call that, viewed across those rotations, averages less than one in six days.
There are no surgical fellowship programs in the Carilion General Surgical Residency. Because of this, general surgery residents are exposed to a tremendous surgical experience in terms of breadth and complexity of operative cases. The teaching faculty members are committed to allow qualified residents perform these operations as chief surgeon. Hence, over the past two years, the graduates of our program conducted an average of 1,200 major operations (with well over 300 majors as surgeon chief) or teaching assistant.