Hierarchical structures American surgery

There are few if any hierarchical structures in American surgery. The surgi cal department consists of general surgery and a variable number of subspec ialties. It usually has a small number of main teaching hospitals, frequent ly in addition to the University Hospital, a County Hospital and a Veterans Administration Hospital. The faculty consists of all physicians who have f inished their specialty training and hold a teaching appointment at the uni versity. The members of the faculty are free and independant in their clini cal teaching and research activities. Each teaching hospital has chief of s urgery and each academic division (i.e. general surgery, cardiovascular sur gery, oncologic surgery) is also headed by a chief of this section. The cha irman of the department represents the department externally and internally , is responsible for the organization and the finances of the department, t he education and training of students and residents as well as quality cont rol relating to clinical activities, research and teaching.