Program Goals & Objectives


The goal of the University of Pennsylvania Colon and Rectal Surgery Residency Program is to produce a well-rounded colon & rectal surgeon with clinical competence in the care of lower gastrointestinal disease.

At the completion of the fellowship, the trainee will have factual knowledge and technical skills with respect to preoperative evaluation, operative management and postoperative care of patients with lower gastrointestinal disease. This includes knowledge of the anatomy and embryology pertinent to the practice of colon & rectal surgery. The trainee will have a thorough understanding of the diagnosis, medical and surgical treatment of benign anorectal and colonic disorders, as well as of functional disorders affecting the lower gastrointestinal tract and pelvic floor.

Competence will be attained in the evaluation and treatment of malignant disease affecting the colon, rectum and anus. This includes knowledge regarding the molecular basis of such disease. The trainee will become familiar with the indications for adjuvant radiation and chemotherapy and with the complications associated with these treatments.

Understanding of the role of both medical therapy and surgery in the treatment of patients with inflammatory bowel disease will be a major goal of the fellowship. This includes the indications for and management of intestinal stomas and complex wounds and fistulae.

Individuals who complete the fellowship will be competent in the selection and performance of patient preparation for, and the prevention and management of complications of, endoscopy of the colon, rectum and anus.

Training will also include techniques for the correct performance and interpretation of endorectal and endoanal ultrasonography and anorectal physiological studies. Trainees will be competent in the interpretation of radiographic studies including:

  • Defecography
  • Bowel transit studies
  • Barium enema
  • CT Ccanning
  • Magnetic Resonance Imaging

Fellows will be knowledgeable in the application of laparoscopic techniques applicable to colon and rectal surgery and be aware of the indications and contraindications to the laparoscopic approach. Fellows will be able to recognize gross and microscopic features of key colon and rectal pathologies and histologies.

It is anticipated that upon completion of the fellowship in colon and rectal surgery, that residents will be prepared to play an active role in the socioeconomic and political climate that has impact on the care that they are able to provide their patients. They will also develop the presentation skills that will allow them to deliver an effective medical presentation.

In an effort to broaden the fellows’ exposure and improve their educational opportunities, they will rotate through three clinical sites in the University of Pennsylvania Health System:

  • Pennsylvania Hospital (PAH)Joshua Bleier, MD, on-site director
  • Hospital of the University of Pennsylvania (HUP)Najjia Mahmoud, MD – on-site director
  • Penn Presbyterian Medical Center (PPMC)Skandan Shanmugan, MD – on-site director
  • In addition, Joshua Bleier, MD will serve in a supervisory role at HUP
  • Cary Aarons, MD will serve in a supervisory role at both HUP and PPMC
  • And Joshua Bleier, MD will serve in a supervisory role at PAH.

Responsibilities of the faculty members include:

  • Direct supervision of the fellows in the outpatient clinic, in the operating room, and in the inpatient setting.
  • Participation in the educational activities of the division, including didactic lectures, journal club, and multi-disciplinary conferences.
  • Regular evaluation of the fellows, providing them with feedback & areas in which they should focus their educational efforts.
  • Providing assistance/guidance to the fellows in their research efforts.

Educational Goals of Colon and Rectal Surgery Fellowship Program

A. Patient Care

Residents will be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents:

  1. Will have training in both diagnostic and therapeutic colonoscopy. The objective is to develop the necessary competence in the use of this procedure to qualify as an expert in the field.
  2. Will develop skills in patient evaluation, examination, office treatment, and surgical aftercare. Such training will include work in the faculty member's outpatient office.
  3. Will have ample opportunity and responsibility for the care of patients with anorectal and colonic diseases.

B. Medical Knowledge

Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents:

Will obtain sufficient knowledge of those aspects of anesthesiology, radiology, and pathology that relate to colon and rectal surgery to develop overall competence as a specialist.

C. Practice-Based Learning and Improvement

Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning. Residents are expected to develop skills and habits to be able to meet the following goals:

  1. Identify strengths, deficiencies, and limits in one’s knowledge and expertise.
  2. Set learning and improvement goals.
  3. Identify and perform appropriate learning activities.
  4. Systematically analyze practice using quality improvement methods, and implement changes with the goal of practice improvement.
  5. Incorporate formative evaluation feedback into daily practice.
  6. Locate, appraise, and assimilate evidence from scientific studies related to their patients’ health problems.
  7. Use information technology to optimize learning.
  8. Participate in the education of patients, families, students, residents and other health professionals.
  9. Teach to contribute to the educational process.

Teaching will be a regular part of the training program. The resident should assist when possible in the instruction of general surgical residents, and medical students, as well as nurses, and other allied health professionals.

D. Interpersonal and Communication Skills

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. Residents are expected to:

  1. Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds.
  2. Communicate effectively with physicians, other health professionals, and health related agencies.
  3. Work effectively as a member or leader of a health care team or other professional group.
  4. Act in a consultative role to other physicians and health professionals.
  5. Maintain comprehensive, timely, and legible medical records.

E. Professionalism

Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:

  1. Compassion, integrity, and respect for others.
  2. Responsiveness to patient needs that supersedes self-interest.
  3. Respect for patient privacy and autonomy.
  4. Accountability to patients, society and the profession.
  5. Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.

F. Systems-Based Practice

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:

  1. Work effectively in various health care delivery settings and systems relevant to their clinical specialty.
  2. Coordinate patient care within the health care system relevant to their clinical specialty.
  3. Incorporate considerations of cost awareness and risk-benefit analysis in patient and/or population based care as appropriate.
  4. Advocate for quality patient care and optimal patient care systems.
  5. Work in interprofessional teams to enhance patient safety and improve patient care quality.
  6. Participate in identifying system errors and implementing potential systems solutions.