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130th Annual Meeting Abstracts

Early Tracking Would Improve Operative Experience of General Surgery Residents
Steven C. Stain1, *Thomas W. Biester2, John B. Hanks3, Stanley W. Ashley4, R. James Valentine5, Barbara L. Bass6, *Jo Buyske2
1Albany Medical College, Albany, NY;2American Board of Surgery, Philadelphia, PA;3University of Virginia, Charlottesville, VA;4Brigham and Women's Hospital, Boston, MA;5University of Texas Southwestern Medical Center, Dallas, TX;6The Methodist Hospital, Houston, TX

High surgical complexity and individual career goals has led most general surgery (GS) residents to pursue fellowship training, resulting in a shortage of surgeons who practice broad based general surgery. We hypothesize that early tracking of residents would improve operative experience of residents planning to be general surgeons, and could foster greater interest and confidence in this career path.
Operative data from GS and fellowship bound residents (FB) applying for the 2008 American Board of Surgery Qualifying Exam (QE) was used to construct a hypothetical training model with 6 months of early specialization (ESP) for FB residents in 4 specialties (cardiac, vascular, colorectal, pediatric); and presumed these cases would be available to GS residents within the same program.
142 training programs had both FB residents (n=237) and GS residents (n=402), and represented 70% of all 2008 QE applicants. GS residents completed a mean of 1091 cases during residency and FB residents performed a mean of 252 cases in the chief year, theoretically making 126 cases available for each GS resident. GS experience and FB Chief are means case #’s; and Total # is the predicted 5 yr GS case volume if ESP was adopted in these programs.
The ESP model improves operative experience of GS residents, particularly for complex gastrointestinal procedures. The expansion of subspecialty ESP should be considered.
OperationGS Experience1/2 FB Chief CasesTotal # (%increase)
Colon resection63.014.377.3(22.8%)
Antireflux procedure7.71.89.5(23.4%)
Pancreatic resection9.13.412.5(37.4%)
Liver resection8.22.410.6(29.3%)
Endocrine procedures35.26.942.1(19.6%)
Trauma operations33.74.538.2(13.4%)
GI endoscopy66.04.371.3(6.5%)


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Saturday, August 17, 2019