Surgery News- July 2008

J U LY 2 0 0 8 • SURGERY NEWS 5 THE THE E Survey Defines Residents’ Vascular Skills BY DOUG BRUNK 20/20 / 0/20 V SION O SIO SION IO Else vier Global Medical Ne ws S A N D I E G O — General surgery residents expect themselves to be more competent with independently performing vascular operations than do vascular surgery program directors, general surgery program directors, or vascular fellows, according to results from a survey. “There are new procedures coming on board in vascular and general surgery [and] general surgery residents are faced with more procedures to learn and less time to learn them in. This has prompted many of us to ask, To what level of competence can and should general surgery residents be trained to perform open vascular and endovascular procedures?” said Dr. Marc E. Mitchell, an ACS Fellow who is chairman of the surgery department and chief of the division of vascular surgery at the University of Mississippi Medical Center, Jackson. He and his associates conducted online surveys with 50 vascular surgery program directors, 115 general surgery program directors, 94 vascular fellows, and 48 general surgery residents. As a guide, they used the American Board of Surgery Resident Operative Experience Report, which consists of nine vascular procedure categories that contain 77 vascular procedures, Dr. Mitchell said at the Vascular Annual Meeting. The survey asked respondents to grade the competency level of finishing general surgery residents for each individual procedure as A (should be competent to perform the procedure independently); B (should be should be familiar with the procedure, but not necessarily competent to perform independently), or C (need not be familiar with or competent to perform independently). Vascular surgery program directors expected general surgery residents to be neither competent in nor familiar with 38% of vascular procedures, and to be competent in just 12%. For vascular fellows, those expectations were 42% and 10%, respectively. General surgery program directors and general surgery residents expected at least familiarity with all vascular procedures. General surgery program directors expected competence in 22% of procedures, whereas for residents that number rose to 26%. Amputation, access surgery, and vascular trauma procedures received the highest category scores from all respondents and had the greatest concurrence. Cerebrovascular and endovascular procedures received the lowest scores from all respondents. Fasciotomy for injury received the single highest score for all procedure categories, followed by below-the-knee amputations. All groups indicated that they expect a moderate level of competence from general surgery residents with regard to procedures for peripheral obstructive disease and aneurysm surgery. “Both vascular surgery program directors and general surgery program directors expect general surgery residents to be familiar with, but not competent to inde- pendently perform, the majority of vascular surgery procedures outside of the amputation and access categories,” Dr. Mitchell said. He added that the data “have implications for curriculum development in general surgery and vascular surgery training programs.” ■ http://www.surgitel.com http://www.surgitel.com http://www.surgitel.com

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Surgery News- July 2008 Contents The 20/20 Vision: Health Reform Trauma: Airway Anchor News From the College: Jacobson Winner General Surgery: Worth the Trouble

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