P. Kandagatla1, A. Woodward1, L. Newman1, L. Petersen1 1Henry Ford Health System,Detroit, MI, USA
Introduction: Despite expansion of surgical breast oncology fellowship programs, little is known about optimal education of general surgery trainees regarding management of breast problems. Our goal was to measure the impact of a dedicated breast surgery rotation on American Board of Surgery In-Service Examination (ABSITE) scores and operative case volumes in a large general surgery training program.
Methods: A dedicated breast surgery rotation was implemented at our program in the academic year of 2016-2017. We obtained the January 2017 ABSITE scores for PGY 1-3 residents, and compared results for the residents that completed the breast surgery rotation prior to the ABSITE to those of residents completing the rotation after taking the ABSITE. We performed a similar comparison for the skin, soft tissue, and breast (SSB) category of ABSITE questions. For the residents that had the rotation prior to the ABSITE, we also compared their 2017 scores to their 2016 scores. We also obtained the case volume totals for residents during the years 2015-2016 and 2016-2017. We compared the average number of major cases and SSB cases between the two groups.
Results: Nine residents completed the breast rotation prior to their ABSITE exam and nine residents completed the rotation after. There was no difference in the average ABSITE overall percentage correct between the two groups of residents (70.2% vs 71.72%, p = 0.55). There was also no difference in the average percentage of SSB questions correct between the two groups (70% vs 71.4%, p = 0.72). The nine residents also did not have a significant change in overall percentage correct when compared to their 2016 scores (69.6% vs 71.3%, p = 0.36). There were 19 PGY 1-3 residents during the 2015-2016 academic year and 17 PGY 1-3 residents during the 2016-2017 academic year. A PGY year-to-year comparison revealed a significant increase in the average number of total major cases among the PGY 1 residents (93.8 cases vs 166.8, p = 0.02). When comparing SSB cases, there was an increase in average cases among the PGY 1 (29.5 cases vs 59.6 cases, p < 0.01) and PGY 2 (58.7 cases vs 72.3 cases, p < 0.02) years.
Conclusion: A dedicated breast surgery rotation had no effect on ABSITE scores, but increased the case volume of both SSB and total major cases among junior residents. Given the new American Board of Surgery requirement for at least 250 operations by the end of the PGY 2 year, implementing a dedicated breast surgery rotation appears to be a valuable strategy for strengthening surgical case volumes and meeting these benchmarks.