Sisak Stephanie, Price Adam D, Foote Darci C, Montgomery Kelsey B, Lindeman Brenessa, Cho Nancy L, Sheu Nora O, Postlewait Lauren M, Smith Savannah R, Markesbery Katherine C, Meister Katherine M, Kader Sarah, Abelson Jonathan S, Anstadt Michael J, Patel Purvi P, Marks Joshua A, Callahan Zachary M, Kimbrough Mary Katherine, Byrd Samuel E, Stopenski Stephen J, Nahmias Jeffry T, Patel Jitesh A, Wilt Wesley, Dodwad Shah-Jahan M, Adams Sasha D, Willis Ross E, Farr Deborah, Harvey Jalen, Woeste Matthew R, Martin Robert C G, Al Yafi Motaz, Sutton Jeffrey M, Cortez Alexander R, Holm Tammy M
Cincinnati Research on Education in Surgical Training (CREST), University of Cincinnati, Department of Surgery, Cincinnati, OH.
Beaumont Health, Department of Surgery, Royal Oak, MI; University of Michigan, Department of Surgery, Ann Arbor, MI.
Surgery. 2024 Jan;175(1):107-113. doi: 10.1016/j.surg.2023.05.048. Epub 2023 Nov 10.
Prior analyses of general surgery resident case logs have indicated a decline in the number of endocrine procedures performed during residency. This study aimed to identify factors contributing to the endocrine operative experience of general surgery residents and compare those who matched in endocrine surgery fellowship with those who did not.
We analyzed the case log data of graduates from 18 general surgery residency programs in the US Resident Operative Experience Consortium over an 11-year period.
Of the 1,240 residents we included, 17 (1%) matched into endocrine surgery fellowships. Those who matched treated more total endocrine cases, including more thyroid, parathyroid, and adrenal cases, than those who did not (81 vs 37, respectively, P < .01). Program-level factors associated with increased endocrine volume included endocrine-specific rotations (+10, confidence interval 8-12, P < .01), endocrine-trained faculty (+8, confidence interval 7-10, P < .01), and program co-location with otolaryngology residency (+5, confidence interval 2 -8, P < .01) or endocrine surgery fellowship (+4, confidence interval 2-6, P < .01). Factors associated with decreased endocrine volume included bottom 50th percentile in National Institute of Health funding (-10, confidence interval -12 to -8, P < .01) and endocrine-focused otolaryngologists (-3, confidence interval -4 to -1, P < .01).
Several characteristics are associated with a robust endocrine experience and pursuit of an endocrine surgery fellowship. Modifiable factors include optimizing the recruitment of dedicated endocrine surgeons and the inclusion of endocrine surgery rotations in general surgery residency.
先前对普通外科住院医师病例记录的分析表明，住院医师培训期间所实施的内分泌手术数量有所下降。本研究旨在确定影响普通外科住院医师内分泌手术经验的因素，并比较那些匹配内分泌外科专科培训的住院医师和未匹配者。
我们分析了美国住院医师手术经验联盟中18个普通外科住院医师培训项目毕业生在11年期间的病例记录数据。
在我们纳入的1240名住院医师中，17名（1%）匹配到内分泌外科专科培训。匹配者处理的内分泌病例总数更多，包括更多的甲状腺、甲状旁腺和肾上腺病例，多于未匹配者（分别为81例和37例，P <.01）。与内分泌手术量增加相关的项目层面因素包括内分泌专科轮转（增加10例，置信区间8 - 12，P <.01）、接受过内分泌培训的教员（增加8例，置信区间7 - 10，P <.01），以及与耳鼻喉科住院医师培训项目同处一地的项目（增加5例，置信区间2 - 8，P <.01）或内分泌外科专科培训项目（增加4例，置信区间2 - 6，P <.01）。与内分泌手术量减少相关的因素包括美国国立卫生研究院资金排名后50%（减少10例，置信区间 - 12至 - 8，P <.01）和专注于内分泌的耳鼻喉科医生（减少3例，置信区间 - 4至 - 1，P <.01）。
有几个特征与丰富的内分泌手术经验及追求内分泌外科专科培训相关。可改变的因素包括优化招聘专门的内分泌外科医生，以及在普通外科住院医师培训中纳入内分泌外科轮转。
