D. H. Rothstein4, A. L. Halverson3, M. Swaroop2 2Northwestern University,Trauma And Critical Care Surgery,Chicago, IL, USA 3Northwestern University,Colon And Rectal Surgery,Chicago, IL, USA 4Women And Children’s Hospital Of Buffalo,Pediatric Surgery,Buffalo, NY, USA
Introduction: While interest in practicing surgery in resource-constrained settings is on the rise among graduating U.S. surgical residents, there is ongoing debate about an optimal humanitarian skill set for surgeons who chose to work in such settings. In addition, increased emphasis on general surgery case exposure at the cost of specialty surgery case exposure has been documented, and may have a negative impact on the breadth of resident training. Review of general surgery resident case logs to gauge experience in specialty surgery may provide insight into residents’ readiness for work in resource-limited settings.
Methods: We compared Accreditation Council for Graduate Medical Education general surgery resident case logs from 2003 and 2013 for operations thought to be essential for working in resource-constrained settings. Case numbers for specialty operations were compared by unpaired t-test analysis between the two time periods.
Results: Case averages in hand, pediatric, genitourinary, and gynecologic surgery decreased significantly from 2003 to 2013 (range 22-51%; p<0.0001). Orthopedic surgery case averages were unchanged, and plastic and general abdominal surgery case averages increased (range 30-44%; p<0.0001).
Conclusion: Case mix among graduating U.S. surgical residents has narrowed over the past 10 years. Resident experience in a variety of specialty fields, thought to be essential in resource-constrained settings, decreased markedly over the study period. Residents who intend to work in resource-constrained settings may need to craft individualized residency experiences or pursue post-graduate training in specialty surgery courses to best prepare for such work.