W. H. Ward2, L. M. Fluke1, C. S. McEvoy1, J. L. Fitch3, R. L. Ricca1 1Naval Medical Center Portsmouth,Department Of General Surgery,Portsmouth, VA, USA 2Fox Chase Cancer Center,Philadelphia, PA, USA 3University Of Texas Health Science Center At Houston,Houston, TX, USA
Introduction: Due to multiple factors, surgical residents may be exposed to fewer complex hepatobiliary cases affecting comfort levels. Within the Military Healthcare System, surgeon training is variable with regard to exposure and volume. This investigation examines differences in training, volume, and operative comfort with complex general surgical procedures.
Methods: A total of 174 active duty Navy surgeons were surveyed concerning training, military station, current volume, and comfort level with complex general surgical procedures. Forty-seven surveys were returned. Board certified surgeons caring for adult patients were included. Comparisons were made between surgeons at regional military treatment facilities versus those at smaller hospitals, surgeons trained within the military versus out-service residency training, and surgeons who had or had not completed a fellowship.
Results:Males comprised 74%, median age was 42, and median time in practice was 5 years. Twenty-one percent were civilian-trained surgeons and 60% completed a fellowship. Sixteen (38%) surgeons were stationed at regional medical centers while the majority was assigned to smaller hospitals. There were no significant differences in procedure comfort based on fellowship training or residency training site. Subjective level of comfort with procedures did not correlate with actual surgical volume.
Conclusion:This review demonstrates that within the Military Health System, there is no subjective advantage to the completion of sub-specialty fellowship training. Additionally, there appears to be no difference between military or civilian residency training with regard to the individual surgeon’s comfort with complex procedures.
