American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Oregon Health & Science University

Oregon Health & Science University
Portland, OR

Number of Positions Available: 2

Contact Information

TTP Chief

Karen J. Brasel, MD, FACS

Additional Contact Information

Department of Surgery
3181 SW Sam Jackson Park Road L223
Portland, OR 97239
Phone: 503-494-7758
Fax: 503-494-5615

Administrative Contact: Sally Rodgers,, 503-494-4939


Program Highlights

During the first two months, the TTP Associate will share call with the faculty members and meet referring physicians. Direct supervision will progress to independent practice as skills are attained. Regular endoscopy clinics will also be scheduled throughout the year with opportunities for experience in gynecology, otolaryngology, urology, and orthopedic surgery. Monthly assessments will evaluate progress, review performance, and plan for the following month.

Program Description

The TTP Associate will work in two Oregon hospitals, Mid-Columbia Medical Center in The Dalles, OR, and Columbia Memorial Hospital in Astoria, OR. Upon arrival at the training site, the TTP Associate will undergo a baseline evaluation of a minimum of five supervised general surgical operations chosen from among the following: open or laparoscopic appendectomy, inguinal hernia repair, cholecystectomy, and/or incisional hernia repair. The intake assessment will be used to identify the level of performance of the TTP Associate and to plan his or her subsequent curriculum and experiences.

The TTP Associate will share call and procedures with the TTP faculty members at the site for the first two months, including taking call for the Emergency Department, seeing patients in the ambulatory setting, performing operations and endoscopic procedures, rounding daily on inpatients, and taking consultations from the hospital, with the TTP Associate conferring with the TTP faculty regarding management decisions. The TTP Associate will make rounds with a TTP faculty member on all inpatients daily during the first two months and will have direct supervision for all operations. The TTP Associate will meet with the majority of the referring physicians during the first two months so that they can become familiar with the TTP Associate’s background and desire to be consulted for appropriate cases. The TTP Associate’s performance will be assessed at the end of each month and the TTP Associate will meet with the Senior Associate to decide at that time whether the TTP Associate is ready to enter the Emergency Call Schedule as an independent practitioner. The TTP faculty will continue to be available to provide consultation and advice for any cases in which there are questions and a weekly case presentation conference will be held to discuss representative cases.

The degree of supervision required will be reviewed monthly. Every attempt will also be made to include patient care and operative experience with caesarean sections and other basic gynecologic conditions as well as basic emergency and elective conditions in the areas of otolaryngology, urology, and orthopedic surgery. In addition to basic general surgical procedures, gastrointestinal endoscopy will be a major feature of the TTP Associate’s curriculum, with regularly scheduled endoscopy clinics. The practice group will hold a regularly scheduled morbidity and mortality conference at which all deaths and complications are discussed using a root cause analysis format.

The TTP Associate will meet monthly with the Senior Associates for evaluation and feedback using a competency-based assessment tool. At this meeting the goals and objectives for the next month will be mutually discussed and decided upon.

A semiannual review will be scheduled to include the TTP Associate, the Senior Associate from each hospital, and the TTP Chief to assess performance based on the goals and objectives that were established at the intake assessment. This will also be an opportunity to refine goals and objectives predicated on the performance and recognized needs to date.

The TTP Associate will learn about practice management issues including billing, collections, medical liability, contract negotiations, quality improvement, and patient safety initiatives from the primary faculty as well as from the practice manager of the surgical group.

Senior Associates

Richard A. Crass, MD, FACS, Columbia Memorial Hospital, Astoria
Ann Rust, MD, Mid-Columbia Medical Center, The Dalles

John G. Hunter, MD, FACS, Mackenzie Professor and Department Chair, TTP Chief 

Columbia Memorial Hospital General Surgery Team in Astoria, Oregon 

Columbia Memorial Hospital in Astoria 

Upper terminal of the Portland Aerial Tram and Peter O. Kohler Pavilion at sunrise 

Tram at sunset