The role of house staff in undergraduate surgical education.

An analysis of the contribution made by house officers in fulfilling the objectives for a comprehensive clerkship experience was undertaken by questioning members of the 1975 medical class. The objectives examined over a broad spectrum of surgical disease and are applicable to any general surgical clerkship. In addition, the instruction received in technical skills was analyzed and deficiencies were noted. Major subject areas related to surgical disease were examined for adequacy of house staff instruction, and an estimation of hours per week devoted to the clerkship experience by house and staff was derived. The university-private hospital training program at this institution permitted a comparison of instruction between these clerkship settings. Some deficiencies did appear in intellectual and technical instruction in both clerkship environments. These deficiencies, however, usually were related to a paucity of patient material and to the lack of opportunity for clinical instruction which ensues from these cases. With few exceptions, the house staff provided nearly one third of the knowledge base acquired during the junior medical student experience. The results indicate that very little difference exists between the didactic role of the house officer in either the university or community hospital environment.