Journal of surgical education
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The American Board of Surgery In-Training Exam (ABSITE) is administered to all general surgery residents annually. Given the recent changes in the format of the examination and in the material being tested, it has become increasingly difficult for residents to prepare for the ABSITE. This is especially true for incoming postgraduate year (PGY) 1 residents because of the respective variability of the surgical clerkship experience. There have been many studies in the past that support the use of weekly assigned readings and examinations to improve ABSITE scores. Other studies have investigated the study habits of residents to determine those that would correlate with higher ABSITE scores. However, there is a lack of information on whether completing review questions plays an integral role in preparing for the ABSITE. We hypothesize that those residents who completed more review questions performed better on the ABSITE. ⋯ Recent changes in the format of the ABSITE to a 2-tiered examination in 2006 and subsequent plan to return to a unified test for all PGY levels has made preparation difficult. With a more focused, question-based approach to studying, residents may see a demonstrable improvement in their scores. Our study supports this hypothesis-showing that residents who complete more review questions had higher ABSITE percentile scores. In the past, it has been demonstrated that strong ABSITE scores are associated with higher written board scores. With the widespread adoption of the Surgical Council on Resident Education curriculum, we postulate that residency programs that rely on this review question-based curriculum will report improved ABSITE percentile scores and written board pass rates.
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The spectrum of the surgeon-scientist ranges from a clinician who participates in the occasional research collaboration to the predominantly academic scientist with no involvement in clinical work. Training surgeon-scientists can involve resource-intense and lengthy training programs, including Masters and PhD degrees. Despite high enrollment rates in such programs, limited data exist regarding their outcome. The aim of the study was to investigate the scientific productivity of general surgeons who completed Masters or PhD graduate training compared with those who completed clinical residency training only. ⋯ The volume and impact of research publication of PhD-trained surgeon-scientists are significantly higher than those having clinical-only and Masters training. The additional 1 or 2 years of training to obtain a PhD over a Masters degree significantly nurtures trainees to hone research skills within a supervised environment and should be encouraged for research-inclined residents.
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Development and maintenance of scholarly activity is a challenge for small community-based surgical training programs. The current Accreditation Council for Graduate Medical Education Program Requirements in General Surgery states that, "Residents should participate in scholarly activity," and "The sponsoring institution and program should allocate adequate educational resources to facilitate resident involvement in scholarly activities." We adopted a program designed to improve the quality of research projects pursued by surgical residents and to increase the number of projects submitted for both presentation and publication. ⋯ A structured scholarly activity program positively affects the number of clinical projects produced by a small community-based surgical training program. Familiarity with project design and biostatistics, plus one-on-one mentoring improves the quality of research produced. A potential additional benefit is the ability to involve private surgical faculty with the residents' projects.
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Establish a competency-based system for advancement of postgraduate year (PGY) I residents to take at-home call, with indirect and direct supervision available. ⋯ We present an Accreditation Council for Graduate Medical Education-approved innovative project, which appears to have been successful in implementing at-home call for PGY I residents. This enables the progressive development of PGY I residents and assists our CCC in the development of competency-based milestones for advancement. The effect of this project is significant for those residency programs where incorporation of at-home call is possible.
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Observational Study
Surgeon as educator: bedside ultrasound in hypertrophic pyloric stenosis.
Our institution has demonstrated the diagnostic accuracy of surgeon-performed ultrasound (US) in the diagnosis of hypertrophic pyloric stenosis (HPS). Moreover, we have also shown this modality to be accurate and reproducible through surgeon-to-surgeon instruction. The purpose of this study was to determine whether a surgical resident with experience in diagnosing HPS can teach pediatric emergency medicine (PEM) fellows, with little experience in sonography, to accurately measure the pyloric channel with bedside US. ⋯ Bedside-performed US technique for measuring the pylorus length and width in patients with HPS is reproducible and accurate when taught to PEM providers. The learning curve for this technique is short.