Department of Visceral- and Transplantation Surgery, Zurich University Hospital, Universitätsspital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
Department of Health Sciences and Technology (HEST), ETH Zurich, Zürich, Switzerland.
World J Surg. 2020 Sep;44(9):2850-2856. doi: 10.1007/s00268-020-05552-9.
The landscape of surgical training has been subject to many changes over the past 15 years. This study examines resident satisfaction, determinants of satisfaction, demographics, working hours and the teaching rate of common operations in a longitudinal fashion with the aim to identify trends, shortcomings and possible ways to improve the current training system.
The Swiss Medical Association administers an annual survey to all Swiss residents to evaluate the quality of postgraduate medical training (yearly respondents: 687-825, response rate: 68-72%). Teaching rates for general surgical procedures were obtained from the Swiss association for quality management in surgery.
During the study period (2003-2018), the number of surgical residents (408-655 (+61%)) and graduates in general surgery per year (42-63 (+50%)) increased disproportionately to the Swiss population. While the 52 working hour restriction was introduced in 2005 reported average weekly working hours did not decline (59.9-58.4 h (-3%)). Workplace satisfaction (6 being highest) rose from 4.3 to 4.6 (+7%). Working climate and leadership culture were the main determinants for resident satisfaction. The proportion of taught basic surgical procedures fell from 24.6 to 18.9% (-23%).
The number of residents and graduates in general surgery has risen markedly. At the same time, the proportion of taught operations is diminishing. Despite the introduction of working hour restrictions, the self-reported hours never reached the limit. The low teaching rate combined with the increasing resident number represents a major challenge to the maintenance of the current training quality.
在过去的 15 年中，外科培训的格局发生了许多变化。本研究以纵向方式检查住院医师的满意度、满意度的决定因素、人口统计学、工作时间和常见手术的教学率，旨在确定趋势、缺点和可能改进当前培训系统的方法。
瑞士医师协会每年向所有瑞士住院医师进行一次调查，以评估研究生医学培训的质量（每年受访者：687-825 人，回复率：68-72%）。一般外科手术的教学率是从瑞士外科质量保证协会获得的。
在研究期间（2003-2018 年），外科住院医师的数量（408-655 人（增加了 61%））和每年的普通外科毕业生人数（42-63 人（增加了 50%））与瑞士人口不成比例地增加。虽然 2005 年引入了 52 小时工作限制，但报告的平均每周工作时间并未减少（59.9-58.4 小时（减少 3%））。工作场所满意度（最高为 6 分）从 4.3 上升到 4.6（增加了 7%）。工作环境和领导文化是住院医师满意度的主要决定因素。教授的基本手术比例从 24.6%下降到 18.9%（减少了 23%）。
普通外科的住院医师和毕业生人数显著增加。与此同时，教授手术的比例正在减少。尽管引入了工作时间限制，但自我报告的工作时间从未达到限制。低教学率与住院医师人数的增加相结合，对维持当前培训质量构成了重大挑战。
