A Qualitative Study of the Barriers and Benefits to Resident Education in Ambulatory Surgical Centers

Zale, Andrew D.; Song, Christopher; Lai, Jonathan; Jang, Minyoung; Lipsett, Pamela A.; Desai, Sanjay V.; Hanyok, Laura A.; Bienstock, Jessica L.

doi:10.1016/j.jsurg.2021.04.002

Cited by 5 publications

(2 citation statements)

References 43 publications

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“…The requirement for PDs to act as protectors of learners is a paradigm that has been tested in many different crucibles of modern residency training: sleep and fatigue mitigation; maximizing educational benefit and reducing nonphysician obligations; and the growing and urgent emphasis on trainee well-being and resilience, especially given the higher risk of death by suicide for physicians. [26][27][28][29][30][31][32] These examples may demonstrate selected circumstances in which PDs advocate for individuals or groups of residents. However, it is difficult to compare these situations with the advocacy required by PDs on behalf of their residents during the pandemic, given the enormity and scale with which COVID-19 threatened entire programs of residents working on the frontlines.…”

Section: Discussionmentioning

confidence: 99%

Residency Program Responses to Early COVID-19 Surges Highlight Tension as to Whether Residents Are Learners or Essential Workers

Martin¹,

Finn²,

Kisielewski³

et al. 2022

Academic Medicine

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Purpose To quantify the extent to which internal medicine (IM) residents provided care for patients with COVID-19 and examine characteristics of residency programs with or without plans (at some point) to exclude residents from COVID-19 care during the first 6 months of the pandemic. Method The authors used data from a nationally representative, annually recurring survey of U.S. IM program directors (PDs) to quantify early (March–August 2020) resident participation in COVID-19 care. The survey was fielded from August to December 2020. PDs reported whether they had planned to exclude residents from COVID-19 care (i.e., PTE status). PTE status was tested for association with program and COVID-19 temporal characteristics, resident schedule accommodations, and resident COVID-19 cases. Results The response rate was 61.5% (264/429). Nearly half of PDs (45.4%, 118/260) reported their program had planned at some point to exclude residents from COVID-19 care. Northeastern U.S. programs represented a smaller percentage of PTE than non-PTE programs (26.3% vs 36.6%; P = .050). PTE programs represented a higher percentage of programs with later surges than non-PTE programs (33.0% vs 13.6%, P = .048). Median percentage of residents involved in COVID-19 care was 75.0 (interquartile range [IQR]: 22.5–100.0) for PTE programs, compared with 95.0 (IQR: 60.0–100.0) for non-PTE programs (P < .001). Residents participated most in intensive care units (87.6%, 227/259) and inpatient wards (80.8%, 210/260). Accommodations did not differ by PTE status. PTE programs reported fewer resident COVID-19 cases than non-PTE programs (median percentage = 2.7 [IQR: 0.0–8.6] vs 5.1 [IQR: 1.6–10.7]; P = .011). Conclusions IM programs varied widely in their reported plans to exclude residents from COVID-19 care during the early pandemic. A high percentage of residents provided COVID-19 care, even in PTE programs. Thus, the pandemic highlighted the tension as to whether residents are learners or employees.

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Section: Discussionmentioning

confidence: 99%

Residency Program Responses to Early COVID-19 Surges Highlight Tension as to Whether Residents Are Learners or Essential Workers

Martin¹,

Finn²,

Kisielewski³

et al. 2022

Academic Medicine

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“…Although the sparse data on the subject suggests fellows do not appreciably increase intraoperative or postoperative complications [15,16], training does have the potential to slow down clinic or extend operative times. For example, many privately held ambulatory surgery centers do not allow trainees to participate in patient care because of concerns that it will compromise efficiency [17]. For private equity practice models that depend on ever-increasing efficiency, training ophthalmologists may become too costly.…”

Section: Key Pointsmentioning

confidence: 99%

Implications of the presence of private equity in ophthalmology: an academic perspective

Patel

Garner

Berkowitz

et al. 2022

Current Opinion in Ophthalmology

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Purpose of reviewPrivate equity acquisitions of ophthalmology private practices have been steadily increasing over the past decade with far-reaching implications. Ophthalmology departments at academic medical centers are not insulated from the impact of this trend.Recent findingsThe limited data on this subject in the ophthalmology literature identify the growing number of practice acquisitions. However, the lack of transparency obfuscates a clear understanding of the effect on patients and practice patterns.SummaryLeaders at academic medical centers need to be aware of surrounding practice consolidation because of private equity as this could affect revenue streams and patient referral patterns, accelerating expansion. Trainees are entering an uncertain job marketplace that may create a compelling argument to practice in an academic medical center ophthalmology department.

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Training in ambulatory surgery. A pending subject in our country

Morales-García,

Docobo Durantez,

Capitán Vallvey

et al. 2023

Cirugía Española (English Edition)

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A Qualitative Study of the Barriers and Benefits to Resident Education in Ambulatory Surgical Centers

Cited by 5 publications

References 43 publications

Residency Program Responses to Early COVID-19 Surges Highlight Tension as to Whether Residents Are Learners or Essential Workers

Residency Program Responses to Early COVID-19 Surges Highlight Tension as to Whether Residents Are Learners or Essential Workers

Implications of the presence of private equity in ophthalmology: an academic perspective

Training in ambulatory surgery. A pending subject in our country

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