Attitudes, Training Experiences, and Professional Expectations of US General Surgery Residents

Abstract

ENERAL SURGERY RESIDENCY training is facing formidable pressures 1,2 and is likely to undergo considerable changes in the coming decade. 3,4 These pressures include diminished attraction to surgery as a profession, 4 increasing interest in surgical subspeciali z a t i o n w i t h 7 0 % o f r e s i d e n t s completing fellowships in 2004, 5,6 and estimated attrition rates of 17% to 26% among categorical general surgery residents (residents who have guaranteed positions in a 5-year training program). 3,7,8 These attrition rates are higher than other medical residencies 2 and have persisted 9 despite major reforms such as elimination of the pyramidal system of residency training. 1 At the same time, a substantial shortage of general surgeons is predicted. 5,10-12 Strategies responding to these complex and competing challenges can be informed by understanding general surgery residents' atti

The perspectives of South African general surgeons regarding their postgraduate training

“…While many surveys have been published of the perceptions of surgical trainees regarding their training, [2] none have canvassed the attitudes of practising surgeons. Gabram et al [3] canvassed recently graduated surgeons, but addressed only their career concerns and not their training.…”

Tracking Residents Through Multiple Residency Programs: A Different Approach for Measuring Residents' Rates of Continuing Graduate Medical Education in ACGME-Accredited Programs

“…Supporting this latter interpretation is a study reporting that almost 30% of surgical residents did not feel confident performing procedures independently following graduation. 9 Another notable finding in our data is that 5% of pipeline graduates reenter another pipeline specialty. Reasons may include dissatisfaction with initial specialty choice, lifestyle factors, need for broader clinical context, and availability of research opportunities.…”

“…Reasons may include dissatisfaction with initial specialty choice, lifestyle factors, need for broader clinical context, and availability of research opportunities. 9,10 Our study has several limitations. First, we limited tracking of residents to the 2-year period following graduation; our estimates do not account for those entering the workforce and then reentering GME training more than 2 years after graduation.…”

“…Our results indicate this trend is shifting, predominantly due to an increase in the number of USMG pipeline graduates continuing training across all specialties in our analysis. Possible explanations for this change include growth in the number and array of subspecialty programs available to residents, [1][2][3] residents' desire to gain a competitive edge, 9 and a real or perceived lack of preparedness to enter practice as graduates of pipeline residencies. Supporting this latter interpretation is a study reporting that almost 30% of surgical residents did not feel confident performing procedures independently following graduation.…”

Surgical Subspecialization: Escape Route for Surgeons or Added Benefit for Patients?

“…In several survey-based attempts to study the selfconfidence of surgical residents, about one-quarter of residents worry that they will be unable to operate independently at the completion of training. 12,13 Regardless of the types of operations being done, surgical residents are losing autonomy overall. Duty hour regulations have soured attendings' attitudes toward trainees, 14,15 and because of a variety of other factors, including supervision regulations, billing stipulations, medicolegal considerations, and productivity pressures, residents do less and less.…”