Steinberg S M, Meyer A A, Flint L M
Department of Surgery, Tulane University, New Orleans, LA.
J Trauma. 1993 Jun;34(6):884-8; discussion 888-9.
Since the development of surgical critical care (SCC) as a discrete body of knowledge and its recognition by the American Board of Surgery (ABS), it has been beset by several controversies. One controversy is that the Residency Review Committee (RRC) for Surgery mandated that approved SCC training be 1 year long with no operative experience. A survey was conducted to determine the opinions and experiences on this controversy and others of 498 surgeons who regularly practice SCC. Seventy percent (349) responded and 100% of these held a Certificate of Added Qualifications in SCC. Only 35% of the respondents had completed a critical care fellowship and 61% were either the director or associate director of an ICU. An overwhelming majority (> 90%) believed that SCC should be considered one of the essentials in training surgeons and that the ABS should continue to offer a Certificate of Added Qualifications. Two thirds disagreed with the RRC's ban on operative experience during SCC fellowships and 71% believed that this prohibition limited the pool of surgical applicants to SCC programs. There were no significant differences in the responses between any of the major subgroups. Interestingly, 50% of the respondents who had completed RRC-approved SCC fellowships stated that their fellowship included operative experience.(ABSTRACT TRUNCATED AT 250 WORDS)
自外科重症监护（SCC）作为一门独立的知识体系发展起来并得到美国外科委员会（ABS）认可以来，它一直饱受诸多争议困扰。其中一个争议是，外科住院医师评审委员会（RRC）规定，经批准的SCC培训为期1年，且不涉及手术经验。为此进行了一项调查，以确定498名经常从事SCC工作的外科医生对这一争议及其他问题的看法和经历。70%（349人）做出了回应，且这些人都拥有SCC的附加资格证书。只有35%的受访者完成了重症监护 fellowship，61%的人担任重症监护病房（ICU）的主任或副主任。绝大多数（>90%）人认为SCC应被视为外科医生培训的基本要素之一，并且ABS应继续提供附加资格证书。三分之二的人不同意RRC关于在SCC fellowship期间禁止手术经验的规定，71%的人认为这一禁令限制了申请SCC项目的外科医生人选范围。任何主要亚组之间的回答均无显著差异。有趣的是，完成RRC批准的SCC fellowship的受访者中有50%表示他们的fellowship包括手术经验。（摘要截取自250字）
