دورية أكاديمية

10 Year Analysis of Pediatric Surgery Fellowship Match and Operative Experience: Concerning Trends?

التفاصيل البيبلوغرافية
العنوان: 10 Year Analysis of Pediatric Surgery Fellowship Match and Operative Experience: Concerning Trends?
المؤلفون: Farooqui Z; Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH.; Department of Surgery, University of Cincinnati, Cincinnati, OH., Cortez AR; Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH.; Department of Surgery, University of Cincinnati, Cincinnati, OH., PottsIII JR; Accreditation Council for Graduate Medical Education, Chicago, IL; and., Tiao GM; Division of Pediatric General and Thoracic Surgery, Cincinnati Children's, Hospital Medical Center, Cincinnati, OH., von Allmen D; Division of Pediatric General and Thoracic Surgery, Cincinnati Children's, Hospital Medical Center, Cincinnati, OH., Quillin RC 3rd; Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH.; Department of Surgery, University of Cincinnati, Cincinnati, OH., Bondoc AJ; Division of Pediatric General and Thoracic Surgery, Cincinnati Children's, Hospital Medical Center, Cincinnati, OH., Garrison AP; Division of Pediatric General and Thoracic Surgery, Cincinnati Children's, Hospital Medical Center, Cincinnati, OH.
المصدر: Annals of surgery [Ann Surg] 2023 Feb 01; Vol. 277 (2), pp. e475-e482. Date of Electronic Publication: 2023 Jan 10.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0372354 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1140 (Electronic) Linking ISSN: 00034932 NLM ISO Abbreviation: Ann Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Specialties, Surgical* , Surgeons*, Humans ; Child ; Fellowships and Scholarships ; Accreditation ; Education, Medical, Graduate
مستخلص: Objective: This paper aims to evaluate the pediatric surgery training pipeline vis-à-vis the pediatric surgery match and operative experience of pediatric surgery fellows.
Summary of Background Data: Pediatric surgery remains a competitive surgical subspecialty. However, there is concern that operative experience for pediatric surgery fellows is changing. This paper examines the selectivity of the pediatric surgery match, along with the operative experience of pediatric surgery fellows to characterize the state of pediatric surgery training.
Methods: The pediatric surgery fellowship match was analyzed from the National Resident Matching Program data from 2010 to 2019. Selectivity among fellowships was compared using analysis of variance with Dunnett test. Operative log data for pediatric fellows was analyzed using the Accreditation Council for Graduate Medical Education case logs from 2009 to 2019. Linear regression analysis was used to evaluate trends in operative volume over time.
Results: Pediatric surgery had the highest proportion of unmatched applicants (47.2% ± 5.3%) and lowest proportion of unfilled positions (1.4% ± 1.6%) when compared to other National Resident Matching Program surgical fellowships. Accreditation Council for Graduate Medical Education case log analysis revealed a statistically significant decrease in cases for graduating fellows (-5.3 cases/year, P < 0.05). Total index cases decreased (-4.7 cases/year, P < 0.01, R 2 = 0.83) such that graduates in 2019 completed 59 fewer index operations than graduates in 2009.
Conclusion: Although pediatric surgery fellowship remains highly selective there has been a decline in the operative experience for graduating fellows. This highlights the need for evaluation of training paradigms and operative exposure in pediatric surgery to ensure the training of competent pediatric surgeons.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
References: Nakayama DK. Vignettes from the history of pediatric surgery. J Pediatr Surg. 2020;55S:1–37.
National Resident Matching Program, Results and Data: Specialties Matching Service 2010-2019 Appointment Years. In: Program NRM, ed. Washington, DC.: NRMP; 2019. https://www.nrmp.org/fellowship-match-data/.
Longo WE, Sumpio B, Duffy A, et al. Early specialization in surgery: the new frontier. Yale J Biol Med. 2008;81:187–191.
Inclan PM, Hyde AS, Hulme M, et al. For love, not money: the financial implications of surgical fellowship training. Am Surg. 2016;82:794–800.
Haller JA Jr. Why pediatric surgery? A personal journey through the first 50 years. Ann Surg. 2003;237:597–606.
Snow BW, Catwright PC, Young MD. Does surgical subspecialization in pediatrics provide high-quality, cost-effective patient care? Pediatrics. 1996; 97:14–17.
Tejwani R, Wang HS, Young BJ, et al. Increased pediatric sub-specialization is associated with decreased surgical complication rates for inpatient pediatric urology procedures. J Pediatr Urol. 2016;12:388e1–388e7.
Abdullah F, Salazar JH, Gause CD, et al. Understanding the operative experience of the practicing pediatric surgeon: implications for training and maintaining competency. JAMA Surg. 2016;151:735–741.
Savoie KB, Kulaylat AN, Huntington JT, et al. The pediatric surgery match by the numbers: defining the successful application. J Pediatr Surg. 2020;55:1053–1057.
Fraser JD, Aguayo P, St Peter S, et al. Analysis of the pediatric surgery match: factors predicting outcome. Pediatr Surg Int. 2011;27:1239–1244.
McCord JH, McDonald R, Leverson G, et al. Motivation to pursue surgical subspecialty training: is there a gender difference? J Am Coll Surg. 2007;205:698–703.
Ryan MW, Johnson F. Fellowship training in otolaryngology-head and neck surgery. Otolaryngol Clin North Am. 2007;40:1311–1322.
Balch CM, Shanafelt TD, Sloan JA, et al. Distress and career satisfaction among 14 surgical specialties, comparing academic and private practice settings. Ann Surg. 2011;254:558–568.
Fonkalsrud EW, O’Neill JA, Jabaji Z, et al. Changing relationship of pediatric surgical workforce to patient demographics. Am J Surg. 2014;207:275–280.
O’Neill JA Jr, Gautam S, Geiger JD, et al. A longitudinal analysis of the pediatric surgeon workforce. Ann Surg. 2000;232:442–453.
Ricketts TC, Adamson WT, Fraher EP, et al. Future supply of pediatric surgeons: analytical study of the current and projected supply of pediatric surgeons in the context of a rapidly changing process for specialty and subspecialty training. Ann Surg. 2017;265:609–615.
Morris JK, Springett AL, Greenlees R, et al. Trends in congenital anomalies in Europe from 1980 to 2012. PLoS One. 2018;13:e0194986.
Johnson SM, Lee WG, Puapong DP, et al. The pediatric surgical team: a model for increased surgeon index case exposure. J Pediatr Surg. 2019;54: 1878–1883.
Barsuk JH, Cohen ER, Feinglass J, et al. Use of simulation-based education to reduce catheter-related bloodstream infections. Arch Intern Med. 2009;169: 1420–1423.
Sturm LP, Windsor JA, Cosman PH, et al. A systematic review of skills transfer after surgical simulation training. Ann Surg. 2008;248:166–179.
Schmidt E, Goldhaber-Fiebert SN, Ho LA, et al. Simulation exercises as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158(5 Pt 2):426–432.
Buckley CE, Kavanagh DO, Traynor O, et al. Is the skillset obtained in surgical simulation transferable to the operating theatre? Am J Surg. 2014;207:146–157.
Wetz RV, Seelig CB, Khoueiry G, et al. Out-of-match residency offers: the possible extent and implications of prematching in graduate Medical Education. J Grad Med Educ. 2010;2:327–333.
Cortez AR, Winer LK, Kassam AF, et al. See none, do some, teach none: an analysis of the contemporary operative experience as nonprimary surgeon. J Surg Educ. 2019;76:e92–e101.
McPheeters MJ, Talcott RD, Hubbard ME, et al. Assessing the accuracy of neurological surgery resident case logs at a single institution. Surg Neurol Int. 2017;8:206.
Cairo SB, Craig W, Gutheil C, et al. Quantitative analysis of surgical residency reform: using case-logs to evaluate resident experience. J Surg Educ. 2019;76:25–35.
تواريخ الأحداث: Date Created: 20210911 Date Completed: 20230208 Latest Revision: 20230224
رمز التحديث: 20231215
DOI: 10.1097/SLA.0000000000005114
PMID: 34508011
قاعدة البيانات: MEDLINE
الوصف
تدمد:1528-1140
DOI:10.1097/SLA.0000000000005114