Division of Pediatric Surgery, Children's of Alabama, Birmingham, Alabama; Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Division of Pediatric Surgery, Children's of Alabama, Birmingham, Alabama.
J Surg Educ. 2021 Sep-Oct;78(5):1438-1442. doi: 10.1016/j.jsurg.2021.01.004. Epub 2021 Jan 20.
The Accreditation Council for Graduate Medical Education (ACGME) monitors fellow case numbers. Previous literature has shown new fellowships detrimentally affecting general surgery residency case numbers. We hypothesize that an increase in pediatric otolaryngology and pediatric urology fellowships would decrease overlapping case numbers in pediatric surgery fellowships.
A review of each specialties' fellowship match results was performed. Publicly available pediatric surgery cases logs were reviewed for overlapping cases including thyroidectomy, parathyroidectomy, branchial cleft cyst excision, thyroglossal duct cyst excision, major neck tumor excision, nephrectomy, orchidopexy, inguinal hernia, and testicular torsion. Analyzed data included average case numbers and number of fellows each year. Linear regression analysis was performed.
We identified a significant increase in fellowship graduates from 2003 to 2018 (p < 0.006). Reviewed cases showed little fluctuation despite an increase in graduates. A decrease in tumor-related nephrectomies and orchidopexies was identified for pediatric surgery fellows (p < 0.001; p < 0.004). Though significant, nephrectomy fluctuation was between 2 and 4 cases. Similarly, we identified a significant rise in thyroidectomies (p < 0.001). Again, the increase was by 3 cases each year.
Despite the increase in number of fellowships, there has been a minimal overall effect on pediatric surgery case volume. Continuing to monitor these trends will help ensure adequate training for all pediatric surgical subspecialties.
研究生医学教育认证委员会（ACGME）监测住院医师的病例数量。先前的文献表明，新的专科住院医师培训项目会对普通外科住院医师培训的病例数量产生不利影响。我们假设增加儿科耳鼻喉科和小儿泌尿科住院医师培训项目，会减少儿科外科住院医师培训项目中的重叠病例数量。
对每个专业的住院医师培训匹配结果进行了回顾。查阅了公开的儿科外科病例日志，包括甲状腺切除术、甲状旁腺切除术、鳃裂囊肿切除术、甲状舌管囊肿切除术、颈部大肿瘤切除术、肾切除术、睾丸固定术、腹股沟疝和睾丸扭转的重叠病例。分析的数据包括平均病例数量和每年的住院医师数量。进行了线性回归分析。
我们发现，2003 年至 2018 年，住院医师培训毕业生人数显著增加（p<0.006）。尽管毕业生人数增加，但审查病例数量波动不大。儿科外科住院医师的肿瘤相关肾切除术和睾丸固定术数量减少（p<0.001；p<0.004）。尽管有显著变化，但肾切除术的波动在 2 到 4 例之间。同样，我们发现甲状腺切除术数量显著增加（p<0.001）。每年增加 3 例。
尽管住院医师培训项目的数量有所增加，但对儿科外科病例量的总体影响很小。继续监测这些趋势将有助于确保所有儿科外科亚专科的培训都得到充分保障。
