Cohn Stephen M, Price Michelle A, Stewart Ronald M, Pruitt Basil A, Dent Daniel L
Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
Am Surg. 2007 May;73(5):433-7.
Less than 50 per cent of surgical critical care (SCC) fellowship positions are filled each year. We surveyed senior surgical residents to determine their opinions regarding a career in SCC and acute care surgery. A survey was sent to 1348 postgraduate year 3, 4, and 5 residents in the United States. Two hundred fifty-one surveys were returned (19% response rate). Whereas 78 per cent were planning to complete a fellowship, 21 per cent expressed interest in SCC. Fifty-six per cent plan to handle SCC problems only for their own patients, whereas 39 per cent plan to turn this management over to a critical care provider. SCC fellowships were considered to be potentially more appealing if the following changes could be made to the existing structure: adding more general surgery (70% of respondents); adding more trauma experience (50%); adding emergency neurosurgery (44%); adding more emergency orthopedics (42%); or decreasing months of critical care (36%). Increasing salary enhanced appeal for 82 per cent. SCC has limited appeal for most senior surgical residents. Theoretical expansion of surgical critical fellowships to include more general or trauma surgery (acute care surgery) increased the level of interest among senior surgical residents.
每年外科重症监护（SCC）专科医师培训岗位的填补率不到50%。我们对高级外科住院医师进行了调查，以确定他们对SCC和急性护理外科职业的看法。向美国1348名三年级、四年级和五年级住院医师发送了调查问卷。共收回251份调查问卷（回复率为19%）。虽然78%的人计划完成专科医师培训，但21%的人对SCC表示感兴趣。56%的人计划只为自己的患者处理SCC问题，而39%的人计划将这种管理工作交给重症监护人员。如果对现有结构做出以下改变，SCC专科医师培训可能会更具吸引力：增加更多普通外科内容（70%的受访者）；增加更多创伤治疗经验（50%）；增加急诊神经外科（44%）；增加更多急诊骨科（42%）；或减少重症监护时长（36%）。提高薪资对82%的人增强了吸引力。SCC对大多数高级外科住院医师的吸引力有限。理论上扩大外科重症监护专科医师培训范围，使其包括更多普通外科或创伤外科（急性护理外科）内容，会提高高级外科住院医师的兴趣度。
