From Spectrum Health (B.N.G.), Grand Rapids, Michigan; University of Wisconsin (B.L.Z.), Madison, Wisconsin; Rutgers University (D.H.L.), Camden, New Jersey; University of Maryland (W.C.C., S.A.T.), College Park, Maryland; Yale University (K.A.D.), New Haven, Connecticut; University of Michigan (H.B.A.), Ann Arbor, Michigan; and Stanford University (D.A.S.), Stanford, California.
J Trauma Acute Care Surg. 2020 May;88(5):629-635. doi: 10.1097/TA.0000000000002585.
Interest in acute care surgery (ACS) has increased over the past 10 years as demonstrated by the linear increase in fellowship applicants to the different fellowships leading to ACS careers. It is unclear why interest has increased, whether various fellowship pathways attract different applicants or whether fellowship choice correlates with practice patterns after graduation.
An online survey was distributed to individuals previously registered with the Surgical critical care and Acute care surgery Fellowship Application Service. Fellowship program directors were also asked to forward the survey to current and former fellows to increase the response rate. Data collected included demographics, clinical interests and motivations, publications, and postfellowship practice patterns. Fisher's exact and Pearson's χ were used to determine significance.
Trauma surgery was the primary clinical interest for all fellowship types (n = 273). Fellowship type had no impact on academic productivity or practice patterns. Most fellows would repeat their own fellowship. The 2-year American Association for the Surgery of Trauma-approved fellowship was nearly uniformly reported as the preferred choice among those who would perform a different fellowship. Career motivations were similar across fellowships and over time though recent trainees were more likely to consider predictability of schedule a significant factor in career choice. Respondents reported graduated progression to full responsibility, further exposure to trauma care and additional operative technical training as benefits of a second fellowship year.
American Association for the Surgery of Trauma-approved 2-year fellows appear to be the most satisfied with their fellowship choice. No differences were noted in academic productivity or practice between fellowships. Future research should focus on variability in trauma training and operative experience during residency and in practice to better inform how a second fellowship year would improve training for ACS careers.
Descriptive, mixed methods, Level IV.
过去 10 年来，急性护理外科（ACS）的兴趣有所增加，这体现在不同的ACS 职业 fellowship申请人数呈线性增长。目前尚不清楚为什么兴趣增加了，是否各种 fellowship 途径吸引了不同的申请者，或者 fellowship 的选择是否与毕业后的实践模式相关。
向先前在外科重症监护和急性护理外科奖学金申请服务中注册的个人分发在线调查。还要求 fellowship 项目主任将调查转发给现任和前任研究员，以提高回复率。收集的数据包括人口统计学、临床兴趣和动机、出版物以及毕业后的实践模式。使用 Fisher's 精确检验和 Pearson's χ 检验来确定显著性。
创伤外科是所有 fellowship 类型的主要临床兴趣（n = 273）。fellowship 类型对学术成果或实践模式没有影响。大多数研究员会重复自己的 fellowship。2 年美国创伤外科协会认可的 fellowship几乎普遍被报告为那些会选择其他 fellowship的人的首选。随着时间的推移，职业动机在各个 fellowship中相似，但最近的学员更倾向于将日程安排的可预测性视为职业选择的重要因素。受访者报告说，毕业后逐渐承担全部责任、进一步接触创伤护理和额外的手术技术培训是第二年 fellowship的好处。
美国创伤外科协会认可的 2 年 fellowship 研究员似乎对自己的 fellowship 选择最满意。在学术成果或实践方面，各 fellowship之间没有差异。未来的研究应集中在住院期间和实践中创伤培训和手术经验的可变性上，以更好地了解第二年 fellowship如何改善 ACS 职业培训。
描述性、混合方法、IV 级。
