Division of Pediatric Surgery, Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Cohen Children's Medical Center, New Hyde Park, NY.
Division of Pediatric Surgery, Department of Surgery, C.S. Mott Hospital, University of Michigan, Ann Arbor, MI.
J Pediatr Surg. 2020 Oct;55(10):2058-2063. doi: 10.1016/j.jpedsurg.2020.02.006. Epub 2020 Feb 15.
Current practice patterns and opinions regarding subspecialization within pediatric surgery are not well known. We aimed to characterize the prevalence of and attitudes surrounding subspecialization within pediatric surgery.
An anonymous survey regarding subspecialization was distributed to all nonresident members of the American Pediatric Surgical Association.
Of 1118 surveys, we received 458 responses (41%). A majority of respondents labeled themselves 'general pediatric surgeons' (63%), while 34% considered themselves general surgeons with a specific clinical focus, and 3% reported practicing solely within a specific niche. Subspecialists commonly serve as consultants for relevant cases (52%). Common niches included oncology (10%) and anorectal malformations (9%). Subspecialists felt to be necessary included transplant (79%) and fetal (78%) surgeons. Opinions about subspecialization were variable: 41% felt subspecialization improves patient care while 39% believe it is detrimental to surgeon well-roundedness. Only 10% felt subspecialists should practice solely within their subspecialty. Practicing at an academic hospital or fellowship program correlated with subspecialization, while length of time in practice did not.
While pediatric surgeons report that subspecialization may benefit patient care, concerns exist regarding the unfavorable effect it may have on the individual surgeon. A better understanding of how subspecialization affects quality and outcomes would help clarify its utility.
Review article.
Level V.
目前，小儿外科学领域内亚专业的实践模式和观点尚不清楚。我们旨在描述小儿外科学亚专业的流行程度和相关态度。
向美国小儿外科学会的所有非住院医师成员分发了一份关于亚专业的匿名调查。
在 1118 份调查中，我们收到了 458 份回复（41%）。大多数受访者将自己标记为“普通小儿外科医生”（63%），而 34%的人认为自己是具有特定临床重点的普通外科医生，3%的人报告仅在特定领域内执业。亚专科医生通常作为相关病例的顾问（52%）。常见的专业领域包括肿瘤学（10%）和肛门直肠畸形（9%）。被认为必要的亚专科医生包括移植（79%）和胎儿（78%）外科医生。对亚专业的看法存在差异：41%的人认为亚专业可改善患者的护理，而 39%的人认为这对医生的全面发展不利。只有 10%的人认为亚专科医生应该只在自己的亚专业领域内执业。在学术医院或进修项目中执业与亚专业相关，而执业时间长短则无关。
虽然小儿外科医生报告说亚专业可能有益于患者护理，但他们对其可能对个别外科医生产生的不利影响存在担忧。更好地了解亚专业如何影响质量和结果将有助于澄清其效用。
综述文章
5 级
