HoSang Kristen M, Gao Terry P, Green Rebecca, Talemal Lindsay, Kuo Lindsay E
Department of General Surgery, Temple University Hospital, Philadelphia, PA.
Department of General Surgery, Temple University Hospital, Philadelphia, PA.
Surgery. 2025 Jan;177:108861. doi: 10.1016/j.surg.2024.07.086. Epub 2024 Oct 22.
Endocrine surgery is a core component of general surgery training. The landscape of endocrine surgery education in surgical residency and association with entrance into endocrine surgery fellowships is unknown.
In total, 353 Accreditation Council for Graduate Medical Education-accredited general surgery program websites were identified and categorized by US region, program type and size, and endocrine surgery educational experience type. Self-identified endocrine surgeons were defined as American Association of Endocrine Surgeons members or fellowship graduates (American Association of Endocrine Surgeons surgeons) or having a thyroid/parathyroid/adrenal practice. Programs that graduated an American Association of Endocrine Surgeons fellow from 2012 onwards were identified, and characteristics associated with endocrine surgery-experience type, self-identified endocrine or American Association of Endocrine Surgeons faculty, and entrance into endocrine surgery fellowship were assessed.
In total, 353 programs were studied. The median number of general surgery residents per program was 25, with 165 (46.7%) small programs (<25 residents) and 188 (53.3%) large (≥25) programs. There were 122 (34.6%) university-based programs, 82 (23.2%) community-based, 139 (39.4%) community-based/university-affiliated, and 10 (2.8%) military. A total 665 self-identified endocrine surgeons were identified at 303 (85.8%) programs; 15 (14.2%) programs had no self-identified endocrine surgeon. There were 361 American Association of Endocrine Surgeons surgeons located at 163 (46.2%) residency programs. In total, 323 (91.5%) programs had information on curriculum/rotations available, 58 (17.9%) with dedicated endocrine surgery educational experiences, 226 (70%) with rotations mixed with other subspecialties, and 39 (12.1%) with none reported. A total 113 (35%) general surgery programs produced a future endocrine surgery fellow and were most likely to be large (81%, P < .001), university-based (64%, P < .001) programs and were more likely to have a self-identified endocrine (102, 90.3%, P = .016) or an American Association of Endocrine Surgeons surgeon (82, 72.6%, P = .004).
Program size and type were strongly associated with endocrine surgery exposure, presence of a self-identified endocrine surgeon, and same-site American Association of Endocrine Surgeons fellowship. Endocrine surgery educational experiences are inconsistent across residencies, and efforts are needed to ensure that surgical residents receive comprehensive, equitable endocrine surgery education.
内分泌外科是普通外科培训的核心组成部分。外科住院医师内分泌外科教育的情况以及与进入内分泌外科专科培训的关联尚不清楚。
总共识别出353个经研究生医学教育认证委员会认证的普通外科项目网站，并按美国地区、项目类型和规模以及内分泌外科教育经验类型进行分类。自我认定的内分泌外科医生定义为美国内分泌外科医生协会成员或专科培训毕业生（美国内分泌外科医生协会外科医生）或从事甲状腺/甲状旁腺/肾上腺手术的医生。确定了2012年起培养出美国内分泌外科医生协会专科培训学员的项目，并评估了与内分泌外科经验类型、自我认定的内分泌或美国内分泌外科医生协会教员以及进入内分泌外科专科培训相关的特征。
共研究了353个项目。每个项目普通外科住院医师的中位数为25名，其中165个（46.7%）为小型项目（<25名住院医师），188个（53.3%）为大型（≥25名）项目。有122个（34.6%）基于大学的项目，82个（23.2%）社区项目，139个（39.4%）社区/大学附属项目，以及10个（2.8%）军事项目。在303个（85.8%）项目中总共识别出665名自我认定的内分泌外科医生；15个（14.2%）项目没有自我认定的内分泌外科医生。在163个（46.2%）住院医师项目中有361名美国内分泌外科医生协会外科医生。总共323个（91.5%）项目有课程/轮转信息，58个（17.9%）有专门的内分泌外科教育经验，226个（70%）的轮转与其他亚专科混合，39个（12.1%）未报告有相关情况。总共113个（35%）普通外科项目培养出了未来的内分泌外科专科培训学员，这些项目最有可能是大型项目（81%，P<.001）、基于大学的项目（64%，P<.001），并且更有可能有自我认定的内分泌外科医生（102名，90.3%，P=.016）或美国内分泌外科医生协会外科医生（82名，72.6%，P=.004）。
项目规模和类型与内分泌外科接触、自我认定的内分泌外科医生的存在以及同地点的美国内分泌外科医生协会专科培训密切相关。内分泌外科教育经验在各住院医师培训中不一致，需要做出努力以确保外科住院医师接受全面、公平的内分泌外科教育。
