Engels Paul T, Versolatto Andrew, Shi Qian, Coates Angela, Rice Timothy J
Department of Surgery, McMaster University, Ontario, Canada.
Trauma Program, Hamilton General Hospital, Hamilton Health Sciences, Ontario, Canada.
Can Med Educ J. 2020 Dec 7;11(6):e54-e59. doi: 10.36834/cmej.69323. eCollection 2020 Dec.
The ability to provide competent operative trauma care is a core objective of general surgery training but recent publications question the ability of graduates to meet this standard. To assess the adequacy of operative trauma exposure during residency, we constructed and analyzed a retrospective trauma operative case log for general surgery residents at a Canadian trauma centre.
The Hamilton General Hospital Trauma Registry was used to identify all patients from July 2008 to June 2018 who underwent a trauma operation on the neck, chest, or abdomen. Medical records were reviewed to determine procedure type and resident presence.
In our study, 417 patients underwent 570 operations (422 abdominal, 103 thoracic, and 45 neck). For the 35 residents that completed their general surgery residency during the study, the median number of trauma laparotomies was 5, with only 14/35 (40%) present for ≥10 trauma operations. Only 10 residents (29%) were exposed to a neck exploration and 18 (51%) exposed to a thoracic operation for trauma.
Operative trauma exposure amongst general surgery residents at an academic Canadian trauma centre was limited. Cumulative operative trauma surgery exposure of a typical graduating resident was inadequate when compared to Canadian and American accrediting-body standards.
提供合格的创伤手术治疗能力是普通外科培训的核心目标，但近期的出版物对毕业生达到这一标准的能力提出了质疑。为了评估住院医师培训期间创伤手术暴露的充分性，我们构建并分析了一家加拿大创伤中心普通外科住院医师的回顾性创伤手术病例日志。
使用汉密尔顿综合医院创伤登记处来识别2008年7月至2018年6月期间所有在颈部、胸部或腹部接受创伤手术的患者。审查病历以确定手术类型和住院医师在场情况。
在我们的研究中，417名患者接受了570次手术（422次腹部手术、103次胸部手术和45次颈部手术）。在研究期间完成普通外科住院医师培训的35名住院医师中，创伤剖腹手术的中位数为5次，只有14/35（40%）的住院医师参与了≥10次创伤手术。只有10名住院医师（29%）进行过颈部探查，18名（51%）进行过创伤性胸部手术。
加拿大一家学术创伤中心的普通外科住院医师的创伤手术暴露有限。与加拿大和美国认证机构的标准相比，典型的毕业住院医师累积的创伤手术暴露不足。
