Ferrada Paula, Ivatury Rao R, Spain David A, Davis Kimberly A, Aboutanos Michel, Fildes John J, Scalea Thomas M
From the Department of Surgery, Virginia Commonwealth University, Richmond, Virginia (P.F., R.R., M.A.); Department of Surgery, Stanford University Medical Center, Stanford, California D.A.S.); Department of Surgery, Yale School of Medicine, New Haven, Connecticut (K.A.D.); Department of Surgery, University of Nevada, Reno, Nevada (J.J.F.); Department of Surgery, Shock Trauma Center, Baltimore, Maryland (T.M.S.); and Department of Surgery, University of Maryland, Baltimore, Maryland.
J Trauma Acute Care Surg. 2017 Jan;82(1):51-57. doi: 10.1097/TA.0000000000001307.
Acute-care surgery (ACS), trauma, and surgical critical care (SCC) fellowships graduate fellows deemed qualified to perform complex cases immediately upon graduation. We hypothesize international fellow rotations can be a resource to supplement operative case exposure.
A survey was sent to all program directors (PDs) of ACS and SCC fellowships via e-mail. Data were captured and analyzed using the REDCap (Research Electronic Data Capture) tool.
The survey was sent to 113 PDs, with a response rate of 42%. Most fellows performed less than 150 operative cases (59.5%). The majority of PDs thought the operative exposure either could be improved or was not enough to ensure expertise in trauma and emergent general surgery. Only a minority of the PDs found their case load exceptional (can be improved: 43%, not enough: 30% exceptional: 27%). Most PDs thought an international experience could supplement the breadth of cases, provide research opportunities, and improve understanding of trauma systems (70%). Ten sites offered international rotations (70%). Most fellowships would be willing to provide reciprocity to the host institution (90%).
The majority of PDs for ACS, trauma, and SCC programs perceive a need for increased quality and quantity of operative cases. The majority recognize international fellow rotations as a valuable tool to supplement fellows' education.
急性护理外科(ACS)、创伤外科和外科重症监护(SCC)专科培训项目培养出的专科住院医师在毕业后即被认为有能力处理复杂病例。我们推测国际住院医师轮转可以作为一种资源来增加手术病例的接触机会。
通过电子邮件向所有ACS和SCC专科培训项目的项目主任(PD)发送了一份调查问卷。使用REDCap(研究电子数据采集)工具收集和分析数据。
共向113名项目主任发送了调查问卷,回复率为42%。大多数住院医师完成的手术病例少于150例(59.5%)。大多数项目主任认为手术接触机会要么可以改进,要么不足以确保在创伤和急诊普通外科方面具备专业技能。只有少数项目主任认为他们的病例量很出色(可以改进:43%,不足:30%,出色:27%)。大多数项目主任认为国际经历可以补充病例的广度、提供研究机会并增进对创伤系统的了解(70%)。有10个机构提供国际轮转机会(70%)。大多数专科培训项目愿意与接收机构提供互惠安排(90%)。
ACS、创伤外科和SCC项目的大多数项目主任认为需要提高手术病例的质量和数量。大多数人认可国际住院医师轮转是补充住院医师教育的宝贵工具。