Perceptions of Graduating General Surgery Chief Residents: Are They Confident In Their Training?
Debate exists within the surgical education community about: 1) whether five years is sufficient time to train a general surgeon, 2) whether graduating chief residents feel confident in their skills, 3) why residents choose to do fellowships and 4) the scope of general surgery practice today.
In May 2013 a 16-question online survey was sent to every general surgery program director in the United States for dissemination to each graduating chief resident (CR).
Of the 297 surveys returned, 76% of CRs trained at university programs, 81% trained at 5-year programs and 28% were going directly into general surgery practice. The 77% of CRs who had done over 950 cases were significantly more comfortable than those who had done less (p<.0001). Only a few CRs were uncomfortable performing a laparoscopic colectomy (7%) or a colonoscopy (6%), while 80% felt comfortable being on call at a Level I trauma center. Compared with other procedures, CRs were most uncomfortable with: open common bile duct explorations (27%), pancreaticoduodenectomies (38%), hepatic lobectomies (48%) and esophagectomies (60%) (p<0.00001). Of those going into fellowships, 67% said they truly had an interest in that specialty and only 7% said it was because they did not feel confident in their surgical skills.
Current graduates of general surgery residencies appear to be confident in their skills, including care of the trauma patient. Fellowships are being chosen primarily because of an interest in the subspecialty. General surgery residency no longer provides adequate training in esophageal or hepatopancreatobiliary surgery.
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ABSTRACT: General surgical training has changed significantly over the last decade with work hour restrictions, increasing subspecialization, the expanding use of minimally invasive techniques, and nonoperative management for solid organ trauma. Given these changes, this study was undertaken to assess the confidence of graduating general surgery residents in performing open surgical operations and to determine factors associated with increased confidence.Journal of Surgical Research 05/2014; 190(2). DOI:10.1016/j.jss.2014.05.014 · 2.12 Impact Factor