Chen Herbert, Hardacre Jeffrey M, Martin Christine, Udelsman Robert, Lillemoe Keith D
Department of Surgery, Blalock 679, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA.
World J Surg. 2002 Jan;26(1):17-21. doi: 10.1007/s00268-001-0175-4. Epub 2001 Nov 26.
During their general surgical rotations, medical students should ideally have exposure to a wide breadth of surgical procedures, especially if they are interested in pursuing surgical careers. To determine their exposure to endocrine surgery during medical school, we surveyed students from more than 20 medical schools who interviewed for general surgery residency positions at our institution over a 2-year period. Questions focused on the total number of index surgical procedures observed during all of their medical school education. Of 211 surveys sent, 146 were returned (66%). The mean age of the students was 26.0 +/- 0.3 years, and 21% were women. The average times spent on general surgery and surgery subspecialty rotations during medical school were 11.1 +/- 0.6 weeks and 7.6 +/- 0.4 weeks, respectively. The mean number of thyroidectomies (2.8 +/- 0.3), parathyroidectomies (1.9 +/- 0.3), and adrenalectomies (0.5 +/- 0.1) observed by the medical students were significantly lower than operations such as mastectomies (9.4 +/- 0.3), coronary bypass surgeries (8.7 +/- 1.4), and laparoscopic cholecystectomies (10.0 +/- 0.7). Furthermore, of these 146 future surgical residents, 34% failed to observe a single thyroid resection, 42% did not see a parathyroidectomy, and 65% failed to see an adrenalectomy. In conclusion, future general surgery residents seem to observe a wide variety of surgical cases, but most have little or no exposure to endocrine surgery. This paucity of exposure may have significant educational and career ramifications.
在普通外科轮转期间,医学生理想情况下应接触广泛的外科手术,尤其是如果他们有意从事外科职业。为了确定他们在医学院期间接触内分泌外科手术的情况,我们对20多所医学院的学生进行了调查,这些学生在两年时间里到我们机构参加普通外科住院医师职位面试。问题集中在他们在整个医学院学习期间观察到的主要外科手术的总数。在发出的211份调查问卷中,有146份被收回(66%)。学生的平均年龄为26.0±0.3岁,21%为女性。医学院期间在普通外科和外科亚专业轮转上花费的平均时间分别为11.1±0.6周和7.6±0.4周。医学生观察到的甲状腺切除术(2.8±0.3)、甲状旁腺切除术(1.9±0.3)和肾上腺切除术(0.5±0.1)的平均数量明显低于乳房切除术(9.4±0.3)、冠状动脉搭桥手术(8.7±1.4)和腹腔镜胆囊切除术(10.0±0.7)等手术。此外,在这146名未来的外科住院医师中,34%没有观察到一例甲状腺切除术,42%没有看过甲状旁腺切除术,65%没有看过肾上腺切除术。总之,未来的普通外科住院医师似乎观察了各种各样的外科病例,但大多数人很少或根本没有接触过内分泌外科手术。这种接触的匮乏可能会产生重大的教育和职业影响。