The state of affairs: Assessing the scope of endocrine surgery exposure in general surgery residencies across the United States.

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.