Targarona Soler Eduardo Ma, Jover Navalon Jose Ma, Gutierrez Saiz Javier, Turrado Rodríguez Víctor, Parrilla Paricio Pascual
Servicio de Cirugía, Hospital de Sant Pau, Barcelona, España.
Servicio de Cirugía, Hospital Universitario de Getafe, Madrid, España.
Cir Esp. 2015 Mar;93(3):152-8. doi: 10.1016/j.ciresp.2015.01.001. Epub 2015 Jan 29.
Residents in our country have achieved a homogenous surgical training by following a structured residency program. This is due to the existence of specific training programs for each specialty. The current program, approved in 2007, has a detailed list of procedures that a surgeon should have performed in order to complete training. The aim of this study is to analyze the applicability of the program with regard to the number of procedures performed during the residency period.
A data collection form was designed that included the list of procedures from the program of the specialty; it was sent in April 2014 to all hospitals with accredited residency programs. In September 2014 the forms were analysed, and a general descriptive study was performed; a subanalysis according to the resident's sex and Autonomous region was also performed. The number of procedures performed according to the number of residents in the different centers was also analyzed.
The survey was sent to 117 hospitals with accredited programs, which included 190 resident places. A total of 91 hospitals responded (53%). The training offered adapts in general to the specialty program. The total number of procedures performed in the different sub-areas, in laparoscopic and emergency surgery is correct or above the number recommended by the program, with the exception of esophageal-gastric and hepatobiliary surgery. The sub-analysis according to Autonomous region did not show any significant differences in the total number of procedures, however, there were significant differences in endocrine surgery (P=.001) and breast surgery (P=.042). A total of 55% of residents are female, with no significant differences in distribution in Autonomous regions. However, female surgeons operate more than their male counterparts during the residency period (512±226 vs. 625±244; P<.01). The number of residents in the hospital correlates with the number of procedures performed; the residents with more procedures trained in hospitals where there were less residents (669±237 vs. 527±209; P=.004).
The surgical activity performed by spanish surgeons is adequate to the specialty program, except in hepatobiliary and esophageal-gastric surgery. The distribution is homogeneous in the different autonomous regions, although there are differences that depend on the number and sex the of residents in each hospital. This information is essential to evaluate the quality of the specialty program and to design new training programs.
我国的住院医师通过遵循结构化的住院医师培训计划，实现了同质化的外科培训。这得益于每个专科都有特定的培训计划。当前的培训计划于2007年获批，其中有一份详细的手术清单，外科医生必须完成这些手术才能结业。本研究的目的是分析该计划在住院医师培训期间所实施手术数量方面的适用性。
设计了一份数据收集表，其中包含该专科培训计划中的手术清单；于2014年4月将其发送给所有拥有经认可的住院医师培训计划的医院。2014年9月对表格进行了分析，并开展了一项一般性描述性研究；还根据住院医师的性别和自治区进行了子分析。同时分析了不同中心根据住院医师人数所实施的手术数量。
该调查问卷被发送至117家拥有经认可培训计划的医院，这些医院共有190个住院医师岗位。共有91家医院回复（53%）。所提供的培训总体上符合专科培训计划。在不同子领域、腹腔镜手术和急诊手术中所实施的手术总数是正确的，或高于该计划推荐的数量，但食管 - 胃手术和肝胆手术除外。根据自治区进行的子分析在手术总数上未显示出任何显著差异，然而，在内分泌外科（P = 0.001）和乳腺外科（P = 0.042）存在显著差异。共有55%的住院医师为女性，在各自治区的分布无显著差异。然而，女性外科医生在住院医师培训期间的手术量多于男性同行（512±226对625±244；P < 0.01）。医院中的住院医师人数与所实施的手术数量相关；在住院医师人数较少的医院接受培训的住院医师实施的手术更多（669±237对527±209；P = 0.004）。
西班牙外科医生开展的手术活动符合专科培训计划，但肝胆和食管 - 胃手术除外。在不同自治区的分布是均匀的，尽管存在一些差异，这些差异取决于每家医院住院医师的数量和性别。这些信息对于评估专科培训计划的质量以及设计新的培训计划至关重要。
