The State of General Surgery: A Different Perspective Foley PJ, Roses RE, Pray LA, Kelz RR, Resnick AS, Williams NN, Mullen JL, Kaiser LR, Morris JB

Changing Learning Climate in Surgical Training ACGME-mandated duty-hour restrictions (2003) Physician extenders Training paradigms for subspecialties Fellowship training Traditional instruction threatened

What Do The Residents Think?

Methods 38-Question Web-Based Survey Sent via E-mail to PD’s at all ACGME-Accredited General Surgery Training Programs Voluntary Responses Collected March – June, 2007 Responses Graded on a 7-Point Scale 1 = Strongly Disagree 4 = Neutral 7 = Strongly Agree

National Resident Survey This slide represents several questions from the web-based survey and the 7 point scale used to score the responses from strongly disagree to strongly agree

Results 997 Responses (14% of Categorical Surgery Residents) 40 States Mean Program Size: 6 Chief Residents (range 2-11) 79% University-Based Residency Programs 30% Female All Clinical Years Well-Represented PGY-5: 15.6% PGY-4: 16% PGY-3: 25.5% PGY-2: 22% PGY-1: 20.9%

Surgical Resident Diversity 67% 14.1% 5.6% 3.4% 4.9% 4.8% The racial composition among the survey respondents was consistent with recent literature. 67% Caucasian 14.1% Asian 5.6% Hispanic 3.4% AA 4.9% Other 4.8% Declined

Fellowship Intentions (Chief Residents) 18% 13% 13%

Perceptions of Surgical Training 86% 85% 85% 84% 71% 63%

Perceptions of Quality of Life 74% 70% 62% 36%

Perceptions of ACGME Duty-Hour Restrictions 82% 80% 70% 47% 47%

Perceptions of ACGME-Duty Hour Restrictions

Perceptions of Surgery as a Profession 88% 87% 77% 70%

Conclusions Surgical Residents are positive about their training. Most feel poorly compensated. Majority intend to pursue fellowship training. Residents are less certain about the effects of ACGME duty-hour restrictions on their training and patient care. Survey may be a useful tool for assessment and comparison.