Ongoing deficits in resident training for minimally invasive surgery

Area of Science:

• Surgical Education
• Minimally Invasive Surgery (MIS)

Background:

• Patient preference has accelerated the adoption of minimally invasive surgery (MIS).
• Surgical residency programs face challenges in training residents in MIS due to steep learning curves and lack of a standardized curriculum.
• Existing Residency Review Committee (RRC) data does not reflect the necessary case volumes for MIS competency.

Purpose of the Study:

• To identify core laparoscopic procedures for MIS training.
• To determine the number of cases required for resident competency in MIS.
• To compare expert recommendations with current resident case volumes.

Main Methods:

• A nationwide survey was distributed to surgical residency programs.
• Expert opinions on essential MIS procedures and required case volumes were collected.
• Survey results were compared against 1998-1999 RRC resident statistics data.

Main Results:

• Experts identified core MIS procedures essential for training.
• Experts consistently recommended significantly higher case volumes for competency than currently performed by residents.
• Current American surgical residency programs do not meet the expert-recommended case range or volume for MIS competency.

Conclusions:

• Residency programs must be restructured to include adequate exposure to core MIS procedures.
• Increased recruitment of expert faculty is necessary to train residents effectively.
• Current training paradigms are insufficient to meet the demand for proficient MIS surgeons.