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General Surgery Residency

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https://www.readbyqxmd.com/read/28813585/association-of-general-surgery-resident-remediation-and-program-director-attitudes-with-resident-attrition
#1
Alexander C Schwed, Steven L Lee, Edgardo S Salcedo, Mark E Reeves, Kenji Inaba, Richard A Sidwell, Farin Amersi, Chandrakanth Are, Tracey D Arnell, Richard B Damewood, Daniel L Dent, Timothy Donahue, Jeffrey Gauvin, Thomas Hartranft, Garth R Jacobsen, Benjamin T Jarman, Marc L Melcher, John D Mellinger, Jon B Morris, Mark Nehler, Brian R Smith, Mary Wolfe, Amy H Kaji, Christian de Virgilio
Importance: Previous studies of resident attrition have variably included preliminary residents and likely overestimated categorical resident attrition. Whether program director attitudes affect attrition has been unclear. Objectives: To determine whether program director attitudes are associated with resident attrition and to measure the categorical resident attrition rate. Design, Setting, and Participants: This multicenter study surveyed 21 US program directors in general surgery about their opinions regarding resident education and attrition...
August 16, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28812156/accredited-residents-perform-colonoscopy-to-the-same-high-standards-as-consultants
#2
Dedrick Kok Hong Chan, Reuben Kong Min Wong, Khay Guan Yeoh, Ker-Kan Tan
BACKGROUND: Endoscopy remains a critical component of General Surgery and Gastroenterology training. Whilst residents need to gain experience, the quality of endoscopy which patients receive cannot be compromised. We conducted this study to compare quality indicators between consultants and residents with regards to colonoscopy. METHODS: A review of colonoscopies from a prospectively collected database was performed from September 2011 to February 2016. Quality indicators such as caecum intubation rate, adenoma detection rate, adherence to a 6-min withdrawal rule, mean number of polyps detected per colonoscope, and complications were collected and compared between the two groups...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28807881/taking-the-initiative-risk-reduction-strategies-and-decreased-malpractice-costs
#3
Steven E Raper, Deborah Rose, Mary Ellen Nepps, Jeffrey A Drebin
BACKGROUND: To heighten awareness of attending and resident surgeons regarding strategies for defense against malpractice claims, a series of Risk Reduction Initiatives (Initiatives) have been carried out in our Department of Surgery (Surgery). We hypothesized that emphasis on certain aspects of risk might be associated with decreased malpractice costs. The relative impact of Surgery Initiatives was assessed when compared to malpractice experience for the rest of the Clinical Practices of the University of Pennsylvania (CPUP)...
August 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28807476/a-model-for-a-career-in-a-specialty-of-general-surgery-one-surgeon-s-opinion
#4
Bona Ko, Christopher R McHenry
BACKGROUND: The integration of general and endocrine surgery was studied as a potential career model for fellowship trained general surgeons. METHODS: Case logs collected from 1991-2016 and academic milestones were examined for a single general surgeon with a focused interest in endocrine surgery. Operations were categorized using CPT codes and the 2017 ACGME "Major Case Categories" and there frequencies were determined. RESULTS: 10,324 operations were performed on 8209 patients...
August 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28802786/transition-to-practice-a-global-surgery-approach
#5
Dustin K Donley, Cassandra K Graybill, Arega Fekadu, Tamara N Fitzgerald, Ryan A Hayton
OBJECTIVE: To determine the feasibility of a global surgery setting for a transition to practice experience. SETTING: A rural hospital in Malawi, Africa. PARTICIPANTS: A recent graduate of a U.S. general surgery residency program. RESULTS: Fellow performed 305 cases across the surgical disciplines with demonstrated improvements in operative ability. CONCLUSION: The global surgery approach to transition to practice offers a unique opportunity to complement domestic training while providing critical assistance to communities with few surgical providers...
August 9, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28802188/risk-of-uterine-cancer-for-brca1-and-brca2-mutation-carriers
#6
Y C Lee, R L Milne, S Lheureux, M Friedlander, S A McLachlan, K L Martin, M Q Bernardini, C Smith, S Picken, S Nesci, J L Hopper, K A Phillips
BACKGROUND: Whether BRCA1 and BRCA2 mutation carriers have a clinically relevant elevated risk of uterine cancer has implications for risk-reducing surgery. AIM: This multicentre, prospective cohort study assessed uterine cancer risk for mutation carriers compared with the general population. METHODS: Eligible mutation carriers were enrolled in the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab) cohort study, had a uterus present and no history of uterine cancer at cohort entry...
August 9, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#7
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28795335/encouraging-mindfulness-in-medical-house-staff-via-smartphone-app-a-pilot-study
#8
Louise Wen, Timothy E Sweeney, Lindsay Welton, Mickey Trockel, Laurence Katznelson
BACKGROUND: Stress and burnout are increasingly recognized as urgent issues among resident physicians, especially given the concerning implications of burnout on physician well-being and patient care outcomes. OBJECTIVE: The authors assessed how a mindfulness and meditation practice among residents, supported via a self-guided, smartphone-based mindfulness app, affects wellness as measured by prevalidated surveys. METHODS: Residents in the departments of general surgery, anesthesia, and obstetrics and gynecology were recruited for participation in this survey-based, four-week, single-arm study...
August 9, 2017: Academic Psychiatry
https://www.readbyqxmd.com/read/28781134/psychological-effect-of-a-mass-casualty-event-on-general-surgery-residents
#9
William S Havron, Karen Safcsak, Joshua Corsa, Andrew Loudon, Michael L Cheatham
OBJECTIVE: To evaluate the psychological effect of a mass casualty shooting event on general surgery residents. DESIGN: Three and 7 months following the Pulse nightclub mass casualty shooting, the mental well-being of general surgery residents employed at the receiving institution was evaluated. A voluntary and anonymous screening questionnaire for posttraumatic stress disorder (PTSD) and major depression (MD) was administered. Responses were stratified into 2 groups; residents who worked (ON-CALL) and residents who did not work (OFF-CALL) the night of the event...
August 3, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28781132/-taking-training-to-the-next-level-the-american-college-of-surgeons-committee-on-residency-training-survey
#10
Richard B Damewood, Patrice Gabler Blair, Yoon Soo Park, Linda K Lupi, Rachel Williams Newman, Ajit K Sachdeva
OBJECTIVE: The American College of Surgeons (ACS) appointed a committee of leaders from the ACS, Association of Program Directors in Surgery, Accreditation Council for Graduate Medical Education, and American Board of Surgery to define key challenges facing surgery resident training programs and to explore solutions. The committee wanted to solicit the perspectives of surgery resident program directors (PDs) given their pivotal role in residency training. DESIGN: Two surveys were developed, pilot tested, and administered to PDs following Institutional Review Board approval...
August 3, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28763918/-the-association-between-single-nucleotide-polymorphisms-in-il6-il10-genes-and-the-susceptibility-to-primary-hepatic-carcinoma-in-shunde-district-of-foshan-city
#11
X L Wang, X Ye, X F Yu, H Ding, Q Liu, L Liu, S D Chen
Objective: To investigate the association between single nucleotide polymorphisms (SNP) in cytokine IL6, IL10 genes and the susceptibility to primary hepatic carcinoma(PHC) of Shunde district in Guangdong Province. Methods: Patients from two hospitals in Shunde District of Foshan City were selected from October 2010 to October 2012. Case group inclusion criteria includedprimary liver cancer; local residents of Shunde or living in Shunde for more than 10 years. The control group inclusion criteria included: patients visited ENT, general surgery and physical examination department in the same hospital during the same period; Local residents or living in Shunde for 10 years and above...
August 6, 2017: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/28760500/status-of-resident-attrition-from-surgical-residency-in-the-past-present-and-future-outlook
#12
Faris Shweikeh, Alexander C Schwed, Chiu-Hsieh Hsu, Valentine N Nfonsam
OBJECTIVE: To investigate the current rate of attrition in general surgery residency, assess the risk factors, and identify prevention strategies. DESIGN: A literature review of the PubMed and MEDLINE databases, from January 1, 1980 to February 1, 2016, for relevant articles. The calculated attrition rate and the statistically significant influencing factors were the main measures and outcomes. SELECTION: All English language articles that described attrition from a general surgery residency were included...
July 28, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28756968/fundamentals-of-laparoscopic-surgery-not-only-for-senior-residents
#13
Darren R Cullinan, Matthew R Schill, Angelia DeClue, Arghavan Salles, Paul E Wise, Michael M Awad
OBJECTIVE: Fundamentals of laparoscopic surgery (FLS) was developed by the Society of American Gastrointestinal and Endoscopic Surgeons to teach the physiology, fundamental knowledge, and technical skills required for basic laparoscopic surgery. We hypothesize that residents are doing more laparoscopic surgery earlier in residency, and therefore would benefit from an earlier assessment of basic laparoscopic skills. Here, we examine FLS test results and ACGME case logs to determine whether it is practical to administer FLS earlier in residency...
July 27, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28746240/-does-the-organization-of-plastic-surgery-units-into-independent-departments-affect-academic-productivity
#14
Scott N Loewenstein, Stephen Duquette, Nakul Valsangkar, Umakanth Avula, Neha Lad, Juan Socas, Roberto L Flores, Rajiv Sood, Leonidas G Koniaris
BACKGROUND: There is an increased push for plastic surgery units in the United States to become independent departments administered autonomously rather than as divisions of a multispecialty surgery department. The purpose of this research was to determine if there are any quantifiable differences in the academic performance of departments versus divisions. METHODS: Using a list of the plastic surgery units affiliated with The American Council of Academic Plastic Surgeons (ACAPS), unit websites were queried for departmental status and to obtain a list of affiliated faculty...
July 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28743315/tight-intra-operative-blood-pressure-control-versus-standard-care-for-patients-undergoing-hip-fracture-repair-hip-fracture-intervention-study-for-prevention-of-hypotension-hip-hop-trial-study-protocol-for-a-randomised-controlled-trial
#15
Iain Keith Moppett, Stuart White, Richard Griffiths, Donal Buggy
BACKGROUND: Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control...
July 25, 2017: Trials
https://www.readbyqxmd.com/read/28742711/readiness-of-us-general-surgery-residents-for-independent-practice
#16
Brian C George, Jordan D Bohnen, Reed G Williams, Shari L Meyerson, Mary C Schuller, Michael J Clark, Andreas H Meier, Laura Torbeck, Samuel P Mandell, John T Mullen, Douglas S Smink, Rebecca E Scully, Jeffrey G Chipman, Edward D Auyang, Kyla P Terhune, Paul E Wise, Jennifer N Choi, Eugene F Foley, Justin B Dimick, Michael A Choti, Nathaniel J Soper, Keith D Lillemoe, Joseph B Zwischenberger, Gary L Dunnington, Debra A DaRosa, Jonathan P Fryer
OBJECTIVE: This study evaluates the current state of the General Surgery (GS) residency training model by investigating resident operative performance and autonomy. BACKGROUND: The American Board of Surgery has designated 132 procedures as being "Core" to the practice of GS. GS residents are expected to be able to safely and independently perform those procedures by the time they graduate. There is growing concern that not all residents achieve that standard. Lack of operative autonomy may play a role...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28741193/burr-hole-craniostomy-for-chronic-subdural-hematomas-by-general-surgeons-in-rural-kenya
#17
John K Kanyi, Timothy V Ogada, Mark J Oloo, Robert K Parker
INTRODUCTION: Chronic subdural hematoma (cSDH) is a common condition that causes significant morbidity and mortality. In rural sub-Saharan Africa, there are very few neurosurgeons. Yet, cSDH is treatable by relatively simple surgical intervention with potential for rapid clinical improvement. METHODS: We conducted a retrospective chart review of all patients with cSDH who underwent burr-hole trephination at Tenwek Hospital, Kenya, between July 2014 and July 2016...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28734949/the-program-evaluation-committee-in-action-lessons-learned-from-a-general-surgery-residency-s-experience
#18
Shanley B Deal, Heather Seabott, Lily Chang, Adnan A Alseidi
OBJECTIVE: To evaluate the success of the annual program evaluation process and describe the experience of a Program Evaluation Committee for a General Surgery residency program. DESIGN: We conducted a retrospective review of the Program Evaluation Committee's meeting minutes, data inputs, and outcomes from 2014 to 2016. We identified top priorities by year, characterized supporting data, summarized the improvement plans and outcome measures, and evaluated whether the outcomes were achieved at 1 year...
July 19, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28730776/institutional-variations-in-nutritional-aspects-of-enhanced-recovery-pathways-after-elective-surgery-for-colon-cancer
#19
Fotios Seretis, Panagiota Kaisari, Kasun Wanigasooriya, Edward Rawstorne, Charalampos Seretis
PURPOSE: Perioperative nutritional optimisation is one of the key aspects of the Enhanced Recovery after Surgery (ERAS) pathway after elective colorectal cancer resections. Despite the general acceptance of ERAS as a safe and cost-effective perioperative care bundle, significant variations in terms of nutritional support exist among colorectal units. METHODS: To assess these variations, we performed a cross-sectional online survey among colorectal surgical residents within a UK region...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28729189/the-quality-in-training-initiative-giving-residents-data-to-learn-clinical-effectiveness
#20
Morgan M Sellers, Matt Fordham, Craig W Miller, Clifford Y Ko, Rachel R Kelz
BACKGROUND: Training programs are expected to provide clinical outcomes data to residents. Few systems have the necessary infrastructure. We evaluated initial adoption and use of the Quality In-Training Initiative (QITI) platform linking National Surgical Quality Improvement Program (NSQIP) data to trainees. STUDY DESIGN: Proportions of Accreditation Council for Graduate Medical Education general surgery residency programs with differing levels of NSQIP and QITI affiliation were calculated and program characteristics were compared...
July 17, 2017: Journal of Surgical Education
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