The Effect of the 80-Hour Work Week on General Surgery Resident Operative Case Volume

2006 ◽  
Vol 72 (10) ◽  
pp. 924-928 ◽  
Author(s):  
Julie Tran ◽  
Roger Lewis ◽  
Christian De Virgilio
Keyword(s):  
General Surgery ◽  
Median Number ◽  
Case Volume ◽  
General Surgery Residency ◽  
House Calls ◽  
Surgical Residents ◽  
Operative Case ◽  
General Surgery Resident ◽  
Surgery Resident ◽  
Surgery Residency Program

To meet the new duty hour restrictions on July 1, 2003, our general surgery residency program underwent many changes. The purpose of this study was to examine whether the implementation of these changes, made in part to comply with new duty hour restrictions, would adversely impact general surgery residents’ operative volume. The operative cases of categorical surgical residents were recorded from July 1, 2000 to December 31, 2004. The main outcome measure was the median number of operative cases performed by each resident per quarter (a 3-month period). The number of in-house calls each resident took per quarter was also recorded. From 2000 to 2004, the median number of in-house calls per quarter significantly decreased (27, 25, 15, 10, and 14, respectively; P < 0.001). The median number of operative procedures performed did not vary from quarter to quarter (P = 0.49). There was a trend toward an increase in number of cases performed at the postgraduate year (PGY) 1 (P = 0.07) and 2 (P = 0.04) levels, a decrease at the PGY3 level (P = 0.058), and no change at the PGY4 and 5 years. The 80-hour work week did not adversely affect the operative experience of our categorical surgical residents despite significant reductions of in-house call.

Minimally invasive surgery fellowship does not adversely affect general surgery resident case volume: a decade of experience

2013 ◽  
Vol 205 (3) ◽  
pp. 307-311 ◽  
Author(s):  
Peter T. Hallowell ◽  
Mohamed I. Dahman ◽  
Jayme B. Stokes ◽  
Damien J. LaPar ◽  
Bruce D. Schirmer
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
General Surgery ◽  
Case Volume ◽  
General Surgery Resident ◽  
Surgery Resident

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.

Adenoma Detection Rate in Colonoscopy: Does the Participation of a Resident Matter?

2018 ◽  
Vol 84 (6) ◽  
pp. 1064-1068
Author(s):  
Jacquelyn S. Turner ◽  
Desmond Henry ◽  
Ayana Chase ◽  
Dzifa Kpodzo ◽  
Michael C. Flood ◽  
...  
Keyword(s):  
Quality Indicators ◽  
General Surgery ◽  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Screening Colonoscopy ◽  
General Surgery Residency ◽  
Adenoma Detection ◽  
General Surgery Resident ◽  
American Society ◽  
Surgery Resident

Presently, endoscopic procedures are a requirement for training competency for completion of a general surgery residency. There are no studies to date that have assessed whether having a resident perform a colonoscopy impacts quality indicators such as adenoma detection rate (ADR). To retrospectively review ADR in adult patients, who undergo screening colonoscopy at a single institution with (ColFacR) and without (ColFac) the participation of a general surgery resident. A total of 792 patients were identified in the database screening colonoscopies between the ages of 45 and 80 from July 2013 to June 2015. Of those, 501 were reviewed after exclusion criteria. When comparing the ColFac group (n = 316) to the ColFacR group (n = 185), there were no differences between age, gender, body mass index, American Society of Anesthesiologists score, or quality of bowel preparation. The mean number of total polyps, hyperplastic polyps, and adenomatous polyps retrieved were similar between the two groups. There was no difference in the ADR for the ColFac cases and ColFacR cases (25.95% vs 27.03%, respectively, P = 0.834). ADR is similar in elective colonoscopies that were performed with or without a general surgery resident. The participation of a general surgery resident in routine colonoscopies should not impact reported quality indicators.

A Single-institution Experience: The Integrated Vascular Surgery Residency’s Effect on Fellowship and General Surgery Resident Case Volume and Diversity

2014 ◽  
Vol 28 (1) ◽  
pp. 253-259 ◽  
Author(s):  
Megan I. Carroll ◽  
Kathryne Downes ◽  
Branko Miladinovic ◽  
Karl A. Illig ◽  
Paul A. Armstrong ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
General Surgery ◽  
Single Institution ◽  
Case Volume ◽  
General Surgery Resident ◽  
Surgery Resident

Supervisor, Colleague, or Assistant: General Surgery Resident Perceptions of Advanced Practitioners

2018 ◽  
Vol 84 (2) ◽  
pp. 294-299 ◽  
Author(s):  
Clancy J. Clark ◽  
Amy Hildreth ◽  
John Migaly ◽  
Leah Sieren ◽  
Jeffrey Carter ◽  
...  
Keyword(s):  
General Surgery ◽  
Health Care Team ◽  
Academic Medical Centers ◽  
General Surgery Residency ◽  
Resident Perceptions ◽  
Medical Centers ◽  
Academic Medical ◽  
General Surgery Resident ◽  
Surgery Resident

Integration of advanced practitioners (APs) into academic medical centers can improve processes of care and decrease physician workload but may adversely impact general surgery residency training. The aim of the present study was to characterize general surgery resident perceptions of APs and their impact on resident training. We conducted an institutional review board–approved survey covering five topic areas: knowledge of AP training, interaction with APs, scope-of-practice of APs, role of APs in the health-care team, and impact of APs on physician training. The survey was administered to general surgery residents at six large academic medical centers. One hundred eighteen general surgery residents completed the survey. The majority (43.6%) of respondents were junior residents. All respondents had interactions with APs with 90.7 per cent having worked directly with an AP in the last month. Residents reported minimal formal educational involvement by APs with 6.8 per cent reporting participation in didactics and 22.2 per cent teaching operative techniques. Almost half (44.1%) of the respondents reported that APs played an important role in their education, and 42.4 per cent of respondents disagreed or strongly disagreed that the role of the AP is well defined in their hospital. Today's general surgery residents work closely with APs who seem to positively impact resident education. Although residents perceive significant benefit with integration of APs, well-defined roles are lacking.

scholarly journals Cause for concern: Resident experience in operative trauma during general surgery residency at a Canadian centre

2020 ◽  
Author(s):  
Paul Engels ◽  
Andrew Versolatto ◽  
Qian Shi ◽  
Angela Coates ◽  
Timothy Rice
Keyword(s):  
General Surgery ◽  
Trauma Surgery ◽  
Trauma Exposure ◽  
Median Number ◽  
Trauma Centre ◽  
Operative Trauma ◽  
General Surgery Residency ◽  
Operative Case ◽  
General Surgery Training ◽  
Procedure Type

Background: The ability to provide competent operative trauma care is a core objective of general surgery training but recent publications question the ability of graduates to meet this standard. To assess the adequacy of operative trauma exposure during residency, we constructed and analyzed a retrospective trauma operative case log for general surgery residents at a Canadian trauma centre.  Methods: The Hamilton General Hospital Trauma Registry was used to identify all patients from July 2008 to June 2018 who underwent a trauma operation on the neck, chest, or abdomen.  Medical records were reviewed to determine procedure type and resident presence. Results: In our study, 417 patients underwent 570 operations (422 abdominal, 103 thoracic, and 45 neck).  For the 35 residents that completed their general surgery residency during the study, the median number of trauma laparotomies was 5, with only 14/35 (40%) present for ≥10 trauma operations.  Only 10 residents (29%) were exposed to a neck exploration and 18 (51%) exposed to a thoracic operation for trauma.    Conclusions: Operative trauma exposure amongst general surgery residents at an academic Canadian trauma centre was limited. Cumulative operative trauma surgery exposure of a typical graduating resident was inadequate when compared to Canadian and American accrediting-body standards.

scholarly journals Telemedicine Experience of General Surgery Trainees: Impact on Patient Care and Education

2021 ◽  
pp. 000313482110234
Author(s):  
Brandon J Nakashima ◽  
Navpreet Kaur ◽  
Chelsey Wongjirad ◽  
Kenji Inaba ◽  
Mohd Raashid Sheikh
Keyword(s):  
Patient Care ◽  
Surgical Training ◽  
General Surgery ◽  
Southern California ◽  
University Of Southern California ◽  
General Surgery Residency ◽  
Surgical Training Program ◽  
Current Utilization ◽  
Surgery Resident ◽  
The Impact

Objective The COVID-19 pandemic has had a significant impact on patient care, including the increased utilization of contact-free clinic visits using telemedicine. We looked to assess current utilization of, experience with, and opinions regarding telemedicine by general surgery residents at an academic university–based surgical training program. Design A response-anonymous 19-question survey was electronically distributed to all general surgery residents at a single academic university–based general surgery residency program. Setting University of Southern California (USC) general surgery residency participants: Voluntarily participating general surgery residents at the University of Southern California. Results The response rate from USC general surgery residents was 100%. A majority of residents (76%) had utilized either video- or telephone-based visits during their careers. No resident had undergone formal training to provide telemedicine, although most residents indicated a desire for training (57.1%) and acknowledged that telemedicine should be a part of surgical training (75.6%). A wide variety of opinions regarding the educational experience of residents participating in telemedicine visits was elicited. Conclusions The COVID-19 pandemic brought telemedicine to the forefront as an integral part of future patient care, including for surgical patients. Additional investigations into nationwide telemedicine exposure and practice among United States general surgery residencies is imperative, and the impact of the implementation of telemedicine curricula on general surgery resident telemedicine utilization, comfort with telemedicine technology, and patient outcomes are further warranted. Competencies Practice-based learning, systems-based practice, interpersonal and communication skills

A Resident-Driven Mobile Evaluation System Can Be Used to Augment Traditional Surgery Rotation Evaluations

2021 ◽  
pp. 000313482110111
Author(s):  
Kurun Partap S Oberoi ◽  
Akia D Caine ◽  
Jacob Schwartzman ◽  
Sayeeda Rab ◽  
Amber L Turner ◽  
...  
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
General Surgery ◽  
Residency Program ◽  
Evaluation System ◽  
Clinical Rotation ◽  
Web Based ◽  
General Surgery Residency ◽  
Surgery Residency Program ◽  
To Receive

Background The Accreditation Council for Graduate Medical Education requires residents to receive milestone-based evaluations in key areas. Shortcomings of the traditional evaluation system (TES) are a low completion rate and delay in completion. We hypothesized that adoption of a mobile evaluation system (MES) would increase the number of evaluations completed and improve their timeliness. Methods Traditional evaluations for a general surgery residency program were converted into a web-based form via a widely available, free, and secure application and implemented in August 2017. After 8 months, MES data were analyzed and compared to that of our TES. Results 122 mobile evaluations were completed; 20% were solicited by residents. Introduction of the MES resulted in an increased number of evaluations per resident ( P = .0028) and proportion of faculty completing evaluations ( P = .0220). Timeliness also improved, with 71% of evaluations being completed during one’s clinical rotation. Conclusions A resident-driven MES is an inexpensive and effective method to augment traditional end-of-rotation evaluations.

scholarly journals Showcasing a general surgery residency program during the COVID-19 pandemic

2021 ◽  
Author(s):  
Sarah Lund ◽  
Taleen MacArthur ◽  
Jonie Keune ◽  
Teresa Enger ◽  
Jorys Martinez-Jorge ◽  
...  
Keyword(s):  
General Surgery ◽  
Residency Program ◽  
General Surgery Residency ◽  
Surgery Residency Program
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