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General Surgery versus Fellowship : the Role of the Independent Academic Medical Center

General Surgery versus Fellowship : the Role of the Independent Academic Medical Center. Souheil W. Adra, MD Amber W. Trickey, MS Moira E. Crosby, MPH Scott H. Kurtzman, MD * Mark L. Friedell, MD * H. David Reines, MD *

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General Surgery versus Fellowship : the Role of the Independent Academic Medical Center

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  1. General Surgery versus Fellowship: the Role of the Independent Academic Medical Center Souheil W. Adra, MD Amber W. Trickey, MS Moira E. Crosby, MPH Scott H. Kurtzman, MD * Mark L. Friedell, MD * H. David Reines, MD * * Independent Training Program Committee of the Association of Program Directors in Surgery

  2. Disclosures • NONE

  3. Introduction • Fellowship training is increasing among graduates of United States surgical residency programs • Worsening shortage of general surgeons • Reasons leading to fellowship training are not completely understood • The impact of the type of surgery program on fellowship training is unknown • University Academic Medical Centers (UAMC) vs. Independent Academic Medical Centers (IAMC)

  4. Survey Methods • May-August 2011 • Electronic survey 14 multiple-choice questions, 1 open-ended question • Sent to all 250 general surgery program directors • Analyzed the data using Fisher’s exact tests

  5. Results • Respondents are representative of all 250 programs • Any response: N = 91 (36%) • Surveys completed: N = 74 (30%)

  6. Program Characteristics

  7. Program Characteristics, cont.

  8. Distribution of Fellowships UAMC IAMC

  9. Reasons to Pursue Fellowships UAMC IAMC

  10. Reasons to Pursue General Surgery UAMC IAMC

  11. UAMC vs. IAMC Responses

  12. General Surgery by Region

  13. Discussion • There is a perception that IAMC graduates do not have the same opportunities for fellowships as UAMC graduates • IAMCs tend to graduate proportionately more general surgeons than UAMCs • May impact growing general surgeons deficit

  14. Discussion • The 80-hour workweek is perceived by Program Directors to increase the interest in fellowships • Need tactics to attract fellowship trained surgeons back to general surgery

  15. Limitations • Small sample size despite good response rate • underpowered for detection of statistically significant differences • Using program directors’ perception vs. residents • Survey based study: • Self-selection bias • Respondents’ memory • Respondents may be motivated to give answers that present themselves in a favorable light • Selection bias unlikely, representative sample

  16. Conclusions • Residents enter similar types of fellowships in IAMC vs. UAMC • Reasons for career choices were similar in IAMC vs. UAMC • Geographic location of residency may influence choice of career • Trends without statistical significance: • More general surgeons from IAMC • First choice of fellowships from UAMC

  17. Future Studies • Direct surveys of residents • Further evaluation of program type in shaping career choices • Develop strategies for reducing the general surgeon shortage

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