M. P. Taylor1, M. A. Quinn1, J. Burns1 1East Tennessee State University College Of Medicine,Department Of Surgery,Johnson City, TENNESSEE, USA
Introduction: Nationally, 85% of general surgery graduates pursue fellowships reducing the incoming general surgical workforce. The Association of American Medical Colleges predicts a shortage of 41,000 general surgeons by 2025. In recent studies, lack of confidence appears to be a major factor contributing to resident decision to pursue fellowship. We evaluated the level of confidence, level of autonomy, and decision to pursue fellowship at a hybrid academic/community program that historically produces 70% general surgeons.
Methods: An anonymous survey was sent to current residents and attending surgeons at our institution. Participants responded to questions on their experiences of resident autonomy and level of confidence in technical skills using Likert scales along with simple polar questions. Descriptive statistics were calculated.
Results: There were 28 residents (90%) and 15 attending surgeons (54%) that responded. Most attendings (64%) reported during their third year of residency they began performing the majority (more than 75%) of their major cases as surgeon junior (>50% of the case performed independently) while current residents (55%) reported they were performing the majority of their major cases as a second year resident. Attendings reported that upon graduation from residency, they felt fairly comfortable performing major cases independently (64%) and none (0%) reported feeling very comfortable. Most current residents (90%) reported upon graduation they will feel very confident (45%) or fairly confident (45%) performing major cases independently. No residents reported they would not feel confident (0%). 33% of our current chief residents and only 34% of the total general surgery residents at this institution plan to pursue fellowships. 67% of responding surgeon faculty were fellowship trained.
Conclusion: Our study showed that our residents appear to have earlier levels of autonomy and greater levels of confidence than that experienced by our practicing surgeons when they were residents. Though we were not able to determine if this difference was statistically significant it would be worthwhile to further investigate and determine if this finding is due to chance, varying confidence levels, or type of training module implemented at our institution. Our unique program continues to graduate the majority of our surgical residents into successful general surgery practice and variables contributing to this success merit further investigation.