Objectives of the St. Mary's Health Center Rotation (PS1 and PS2)
St. Mary’s Medical Center is an acute care facility located approximately four miles west of Saint Louis University. It is a private hospital that is closely affiliated with several educational programs at Saint Louis University. It is the largest St. Louis facility of the SSM Health Care System (Sisters of St. Mary’s). The SSM System is one of the largest health care systems in the Midwest. The Sisters of St. Mary’s have their residential quarters on the St. Mary’s Medical Center campus in Richmond Heights. The SSM Health Care Network is one of the three major health care providers in the St. Louis metropolitan area. The plastic surgery division at Saint Louis University is the largest provider of plastic surgery services at St. Mary’s Health Center.
The SSM Health Care System also owns and operates Cardinal Glennon Children’s Hospital. The Department of Obstetrics and Gynecology at Saint Louis University has been based at St. Mary’s Health Center and serves as one of the largest high risk pregnancy units in the St. Louis metropolitan area. The neonatology unit is staffed by the neonatology faculty from the Saint Louis University Department of Pediatrics.
There is a fully accredited Rehabilitation Unit on the sixth floor. Patients from Saint Louis University Hospital requiring rehabilitation are often transferred to the St. Mary’s Rehab Unit, thereby allowing the plastic surgery resident follow-up care for patients cared for during the acute phase of their illness at SLUH.
The plastic surgery resident should obtain experience in the following areas:
- An office setting that is less “clinic” oriented and more representative of a private practice environment. The resident will learn how to run an office, efficiently schedule and see patients, understand the overhead issues involved in the practice of medicine, and learn the costs involved in office and patient care.
- Plastic surgery of the breast: This rotation complements the resident’s experience in the management of breast disease including congenital and acquired breast deformities and breast reconstruction.
- Plastic surgery of the lower extremities: St. Mary’s has a large primary care service provided by internists who have joined the SSM PPO. Many of their patients are elderly and present with a variety of lower extremity wounds. Dr. Bernstein participates in the St. Mary’s Wound Care Center. The plastic surgery resident will see patients in the Wound Care Center every Friday afternoon. The resident will learn how to evaluate and treat patient with complex nonhealing wounds. The resident will gain familiarity with the multitude of wound care products as well as their costs and effectiveness for various conditions. Part and parcel of this experience is the care of our increasing geriatric population.
- Surgery of benign and malignant lesions of the skin and soft tissue. This office practice provides the plastic surgery resident exposure and experience in the diagnosis and management of benign and malignant skin disease, most notably basal cell and squamous cell carcinoma and melanoma.
- Perineal and gynecologic reconstruction. The plastic surgery resident will learn how to work with both General Surgeons and Gynecologic Surgeons in the treatment of complex pelvic, perineal and vaginal wounds. This includes complex abdominal wall reconstruction, panniculectomy, vaginal reconstruction, and perineal reconstruction and repair following tumor resection oftentimes with radiation injury.
Progression of core knowledge, clinical skills, surgical technique, clinical judgment and maturity is expected as plastic surgery residents advance from their second year (PS2) to the Chief year (PS3) of residency. Second-year plastic surgery residents (PS2) should become familiar with, and proficient in, surgical techniques such as breast reduction, expander and implant breast reconstruction, excision and repair of facial, trunk and extremity skin cancers, management of nonhealing lower extremity wounds, aesthetic surgery procedures such as liposuction, abdominoplasty, postbariatric procedures, etc. Working in the private office setting, the resident should also develop proficiency in interviewing and communicating with the elective plastic surgery patients. The Chief Resident (PS3) should build upon his/her experience and function as a Chief Resident taking a leadership role in patient selection, management and operative decision making.
Saint Louis University Faculty: Drs. Kraemer and Bernstein