S. D. Waterford1, M. Williams4, P. M. Fisichella3, A. Lebenthal2,3 1Massachusetts General Hospital,Department Of General Surgery,Boston, MA, USA 2Brigham And Women’s Hospital,Division Of Thoracic Surgery,Boston, MA, USA 3Boston VA Healthcare System,Department Of Surgery,Boston, MA, USA 4Oakwood Southshore Medical Center,Department Of General Surgery,Trenton, MI, USA
Introduction: Trauma is the leading cause of death among persons aged 1-44 in the United States and is the 5th leading cause of death overall. It accounts for more lost years of life than atherosclerosis and cancer combined. Trauma education in American medical schools has received little attention. In this pilot project, we sought to quantify the number of curricular hours devoted to each of the 5 leading causes of death in the United States.
Methods: We performed a review of the pre-clinical curriculum at a northeastern Medical School with full LCME accreditation and hospital affiliations with three adult and one pediatric American College of Surgeons verified Level I trauma centers. We tabulated the total number of hours devoted to education of the 5 leading cause of death in the United States and we included class lectures as well as small group case-based meetings with a faculty preceptor. We then compared the total number of curricular hours devoted to trauma to other major causes of death in the United States. For the statistical analysis we used standard ANOVA with a p < 0.05 significance threshold.
Results: Of the leading 5 causes of death, heart disease was the most covered topic with 128 hours of dedicated curriculum time (Table I). Chronic respiratory disease was the second most discussed topic with 80 hours of dedicated curriculum time. The number of hours of curriculum time devoted to heart disease, chronic lower respiratory diseases, malignant diseases, and cerebrovascular diseases far exceeded that devoted to trauma. This was statistically significant for all 5 leading causes of death except cerebrovascular disease. In the first two pre-clinical years of curriculum 6.5 hours were dedicated to trauma. Six hours of tutorial time was devoted to a single trauma case, involving an accidental blunt trauma. A half hour lecture on orthopedic fractures concluded the total time allocation. No lectures were given on the basic management of trauma patients.
Conclusion: A pilot study comparing curricular hours of the 5 leading causes of death demonstrated a statistically significant discrepancy in the allocated time devoted to trauma education compared to other causes. Based on these preliminary data, we advocate a broader multi-institutional study to further ascertain the amount and quality of trauma education in American medical schools.
