Minimally invasive surgery fellowship does not adversely affect general surgery resident case volume: a decade of experience - 16/02/13
, Mohamed I. Dahman, M.D., Jayme B. Stokes, M.D., Damien J. LaPar, M.D., M.Sc., Bruce D. Schirmer, M.D.
Corresponding author. Tel.: +1-434-243-4811; fax: +1-434-243-7272.Abstract |
Background |
With the advent of clinical fellowships in general surgery, there has been a continual debate over the effect on general surgical resident training. Will a fellowship interfere with a chief resident’s experience or case volume? The aim of this study was to test the hypothesis that the presence of an advanced laparoscopic fellow in a tertiary care hospital and residency has had no deleterious effect on chief resident laparoscopic case volume.
Methods |
The operative case logs of graduating residents and fellows from 2001 to 2011 were reviewed, focusing on laparoscopic basic and complex cases and comparing between those 2 groups and comparing residents’ case numbers with the national average published by the Accreditation Council for Graduate Medical Education.
Results |
Residents graduating from 2001 to 2011 (4–6 chief residents per year) performed an average of 989 ± 76.2 laparoscopic cases per graduating chief class, with each chief averaging 207.7 ± 10.7. The average number of laparoscopic basic cases per graduating chief year was 555.3 ± 42.1, with each chief averaging 116.2 ± 4.9. The average number of laparoscopic complex cases per graduating chief year was 434.4 ± 39.2, with each chief averaging 91.5 ± 7.2. Over the same period of time (1 or 2 fellows per year), fellows performed an average of 336 ± 23.3 cases per year. When comparing residents’ total average cases with the national data, the residents performed a similar number of cases (209.9 ± 11.9 vs 195.0 ± 19.5, P = .53). When comparing years when there were 2 clinical fellows vs years with 1 fellow, there was no change in the total number of laparoscopic cases per chief (224.2 vs 195.6, P = .26) and no change in the number of complex laparoscopic cases (97.1 vs 88.7, P = .63). There was a significant difference for basic laparoscopic cases, with a slight decrease when there were 2 fellows (127.8 vs 106.9, P = .04).
Conclusions |
A laparoscopic fellowship has not had an adverse impact on the complex or basic laparoscopic case experience of surgical residents. In a busy academic practice, laparoscopic fellowships and general surgical residency can coexist.
Le texte complet de cet article est disponible en PDF.Keywords : Residents, Fellows, Fellowship, General surgery, MIS fellowship, Laparoscopic fellowship
Plan
| Dr Schirmer serves as a consultant to Allurion Technologies (Wellesley, MA). All other authors declare no conflicts of interest. |
Vol 205 - N° 3
P. 307-311 - mars 2013 Retour au numéro
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