Trends of core versus subspecialty operative procedures completed in general surgery residency training programs

2021 ◽  
pp. postgradmedj-2021-140503
Author(s):  
Faiz Tuma ◽  
Rafael D Malgor ◽  
Nikit Kapila ◽  
Mohamed K Kamel
Keyword(s):  
Residency Training ◽  
General Surgery ◽  
Operative Procedures ◽  
Steady Increase ◽  
Subspecialty Training ◽  
Paediatric Surgery ◽  
Case Volume ◽  
General Surgery Residency ◽  
The Core ◽  
Case Logs

IntroductionGeneral surgery residency involves performing subspecialty procedures in addition to the core general procedures. However, the proportion of core general surgery versus subspecialty procedures during training is variable and its temporal changes are unknown. The goal of our study was to assess the current trends in core general surgery and subspecialty procedure distributions during general surgery residency training.MethodsData were collected from the ACGME core general surgery national resident available report case logs from 2007 to 2019. Descriptive and time series analyses were used to compare proportions of average procedures performed per resident in the core general surgery category versus the subspecialty category. F-tests were conducted to show whether the slopes of the trend lines were significantly non-zero.ResultsThe mean of total procedures completed for major credit by the average general surgery resident increased from 910.1 (SD=30.31) in 2007 to 1070.5 (SD=37.59) in 2019. Over that same period, the number of general, cardiothoracic, plastic and urology surgery procedures increased by 24.9%, 9.8%, 76.6% and 19.3%, respectively. Conversely, vascular and paediatric surgery procedures decreased by 7.6% and 30.7%, respectively. The neurological surgery procedures remain stable at 1.1 procedures per resident per year. A significant positive correlation in the trend reflecting total (p<0.0001), general (p<0.0001) and plastic (p<0.0016) surgery procedures and the negative correlation in the trend lines for vascular (p<0.0006) and paediatric (p<0.0001) surgery procedures were also noted.ConclusionsTrends in overall surgical case volume performed by general surgery residents over the last 12 years have shown a steady increase in operative training opportunity despite the increasing number of subspecialty training programmes and fellowships. Further research to identify areas for improvement and to study the diversity of operative procedures, and their outcomes is warranted in the years to come.

scholarly journals Residents’ perspectives: Does the Saudi general surgery residency training program apply CanMEDS competencies and prepare future leaders?

2020 ◽  
Author(s):  
Deena Hadedeya ◽  
Ghofran Ageely ◽  
Nourah Alsaleh ◽  
Hajar Aref ◽  
Omar Al-Sharqi ◽  
...  
Keyword(s):  
Training Program ◽  
Residency Training ◽  
General Surgery ◽  
Leadership Skills ◽  
Residency Training Program ◽  
Clinical Leadership ◽  
General Surgery Residency ◽  
Healthcare Needs ◽  
Health Advocate ◽  
Personal Qualities

Background: This study investigates leadership skills and Canadian Medical Education Directives for Specialists (CanMEDS) competencies acquisition within the General Surgery Residency Training Program (GSRTP). The Saudi Commission for Health Specialties (SCFHS) incorporates the CanMEDS Competency Framework into its curriculum to prepare the resident for healthcare needs. Methods: This is a descriptive-analytical study. A questionnaire was used to collect data from 117 General Surgery residents (GS) at seven institutes in Jeddah, Saudi Arabia. Results: The GS residents reported an acceptable self-perceived level of Clinical Leadership Skills (mean ± standard deviation). The most dominant skill was working with others (1.98 ± 1.03), followed by demonstrating personal qualities (2.07 ± 0.88), the ability to manage services (2.21 ± 1.37), improving services (2.22 ± 1.84) and last, setting directions (2.39 ± 0.95). Regarding the CanMEDS competencies, the respondents showed a generally positive perception with an “agree” level (Mean = 1.83). Of the CanMEDS competency roles, Collaborator ranked first followed by Professional and then Communicator. Leader competency ranked fourth followed by Health Advocate, Medical Expert and last, Scholar. Conclusion: The GSRTP residents showed satisfactory self-assessed clinical leadership skills and acquirement of the CanMEDS competencies during their training, which will prepare them to lead in the future.

Assessing the competencies in general surgery residency training

2005 ◽  
Vol 62 (1) ◽  
pp. 111-116 ◽  
Author(s):  
Cheryl I. Anderson ◽  
Amy B. Jentz ◽  
L. Rao Kareti ◽  
James M. Harkema ◽  
Keith N. Apelgren ◽  
...  
Keyword(s):  
Residency Training ◽  
General Surgery ◽  
General Surgery Residency

scholarly journals Analysis and implications of changing hepatopancreatobiliary (HPB) case loads in general surgery residency training for HPB surgery accreditation

HPB ◽  
2013 ◽  
Vol 15 (12) ◽  
pp. 1010-1015 ◽  
Author(s):  
Sally Sayeh Daee ◽  
Jeffrey C. Flynn ◽  
Michael J. Jacobs ◽  
Vijay K. Mittal
Keyword(s):  
Residency Training ◽  
General Surgery ◽  
General Surgery Residency

scholarly journals Residency Training in Robotic General Surgery: A Survey of Program Directors

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Lea C. George ◽  
Rebecca O’Neill ◽  
Aziz M. Merchant
Keyword(s):  
Robotic Surgery ◽  
Residency Training ◽  
General Surgery ◽  
Simulation Training ◽  
Program Directors ◽  
Current Approach ◽  
General Surgery Residency ◽  
Electronic Survey ◽  
Surgery Training ◽  
Robotic Surgery Training

Objective. Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. Methods. An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. Results. 20 program directors were surveyed, a majority being from medium-sized programs (4–7 graduating residents per year). Most respondents (73.68%) had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%), with simulation training prior to console use (84.21%). About two-thirds of the respondents (63.16%) believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%). Conclusion. A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training.

Operative Confidence Among U.S General Surgery Residents

2021 ◽  
pp. 000313482110385
Author(s):  
Adel Elkbuli ◽  
Haley Ehrlich ◽  
Toria Gargano ◽  
Kevin Newsome ◽  
Huazhi Liu ◽  
...  
Keyword(s):  
General Surgery ◽  
Online Survey ◽  
Influential Factors ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Binary Outcomes ◽  
Case Volume ◽  
General Surgery Residency ◽  
Operative Case ◽  
Community Teaching

Background General surgery residents (GSRs) must develop operative autonomy skills to practice independently after graduation. We aim to investigate perceived confidence and operative autonomy of GSR physicians in order to identify and address influential factors. Methods A 28-question anonymous online survey was distributed to 23 United States general surgery residency programs. Multivariable logistic regression was used for calculating the adjusted odds ratio (aOR) for binary outcomes. Significance was defined as P-values ≤ .05 or 95% confidence intervals (CIs) >1 or <1. Results There were 120/558 (21.5%) GSR respondents. General surgery residents with >200 overall operative case volume reported significantly higher confidence with minor cases (P = .05) and major cases (P = .02). General surgery residents that performed both minor and major surgeries reported higher confidence with minor cases at 85.7% compared to GSRs that performed mostly minor surgeries (64.7%) and mostly major surgeries (62.5%). General surgery residents who performed >50 minor surgeries during their PGY 1 and 2 were less confident with major cases than GSRs who performed <50 minor surgeries (aOR: 19.98, 95% CI: 1.26, 318). General surgery residents from community teaching hospitals reported higher confidence with major and minor cases than GSRs from university teaching hospitals and combined programs. Conclusion Increased case volume, predominant case type, early surgical experience during PGY 1 and 2 years, and training at community teaching hospitals were identified as the most important factors that positively influence perception of operative confidence and autonomy among GSRs. These may have important implications in the development of future surgeons.

scholarly journals Resident Exposure to Peripheral Nerve Surgical Procedures During Residency Training

2016 ◽  
Vol 8 (2) ◽  
pp. 173-179 ◽  
Author(s):  
Joseph A Gil ◽  
Alan H Daniels ◽  
Edward Akelman
Keyword(s):  
Peripheral Nerve ◽  
Plastic Surgery ◽  
Surgical Procedures ◽  
General Surgery ◽  
Orthopaedic Surgery ◽  
Case Volume ◽  
Peripheral Nerve Surgery ◽  
Case Logs ◽  
Nerve Surgery ◽  
Neurological Surgery

ABSTRACT  Variability in case exposures has been identified for orthopaedic surgery residents. It is not known if this variability exists for peripheral nerve procedures.Background  The objective of this study was to assess ACGME case log data for graduating orthopaedic surgery, plastic surgery, general surgery, and neurological surgery residents for peripheral nerve surgical procedures and to evaluate intraspecialty and interspecialty variability in case volume.Objective  Surgical case logs from 2009 to 2014 for the 4 specialties were compared for peripheral nerve surgery experience. Peripheral nerve case volume between specialties was performed utilizing a paired t test, 95% confidence intervals were calculated, and linear regression was calculated to assess the trends.Methods  The average number of peripheral nerve procedures performed per graduating resident was 54.2 for orthopaedic surgery residents, 62.8 for independent plastic surgery residents, 84.6 for integrated plastic surgery residents, 22.4 for neurological surgery residents, and 0.4 for surgery residents. Intraspecialty comparison of the 10th and 90th percentile peripheral nerve case volume in 2012 revealed remarkable variability in training. There was a 3.9-fold difference within orthopaedic surgery, a 5.0-fold difference within independent plastic surgery residents, an 8.8-fold difference for residents from integrated plastic surgery programs, and a 7.0-fold difference within the neurological surgery group.Results  There is interspecialty and intraspecialty variability in peripheral nerve surgery volume for orthopaedic, plastic, neurological, and general surgery residents. Caseload is not the sole determinant of training quality as mentorship, didactics, case breadth, and complexity play an important role in training.Conclusions

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