Harness J K, Organ C H, Thompson N W
Department of Surgery, University of California, Davis-East Bay, 1411 E. 31st Street, Oakland, California 94602, USA.
World J Surg. 1996 Sep;20(7):885-90; discussion 890-1. doi: 10.1007/s002689900135.
The aim of this study was to determine if the experience of general surgery residents is adequate and effective. The Resident Statistic Summaries (Report C) of the Residence Review Committee (Surgery) for eight academic years from 1986 to 1994 were analyzed. The main outcome measurements were total number of residents and programs, average number of operations performed, maximum number of operations performed, standard deviation, and the most common number of operations performed. For adrenalectomy, the average per resident was 0.98. The maximum range was from 7 to 15. The standard deviations ranged from 1.12 to 2.00. For pancreatic endocrine operations the average per resident was 0.15 with maximums of 3 to 10. For other endocrine procedures (nonthyroid and nonparathyroid) the average per resident was 0.14, with the maximums ranging from 7 to 19. The most common number of any of these procedures performed by U.S. graduates was 0. The number of adrenal, endocrine pancreas, and other less common endocrine procedures available for graduates of U.S. residency training programs is limited. As a consequence, most U.S. resident graduates have little or no experience with any of these procedures. Our findings suggest a strong need for fellowship training for any surgeon hoping to develop expertise in the management of these unusual and infrequent endocrine surgical diseases.
本研究的目的是确定普通外科住院医师的经验是否充足且有效。对1986年至1994年八个学年的住院医师评审委员会(外科)的住院医师统计摘要(报告C)进行了分析。主要结果指标包括住院医师和项目的总数、平均手术例数、最大手术例数、标准差以及最常见的手术例数。对于肾上腺切除术,每位住院医师的平均例数为0.98。最大范围为7至15例。标准差范围为1.12至2.00。对于胰腺内分泌手术,每位住院医师的平均例数为0.15,最大例数为3至10例。对于其他内分泌手术(非甲状腺和非甲状旁腺),每位住院医师的平均例数为0.14,最大例数范围为7至19例。美国毕业生进行的这些手术中最常见的例数为0。美国住院医师培训项目的毕业生可进行的肾上腺、内分泌胰腺及其他不太常见的内分泌手术数量有限。因此,大多数美国住院医师毕业生对这些手术几乎没有或完全没有经验。我们的研究结果表明,对于任何希望在这些不常见且罕见的内分泌外科疾病管理方面发展专业技能的外科医生,强烈需要进行专科培训。