Bringing order to the chaos: developing a matching process for minimally invasive and gastrointestinal postgraduate...

Since 1993, there has been an increase in the number of postgraduate fellowships in minimally invasive and gastrointestinal (GI) surgery; from 9 in 1993 to more than 80 in 2004. Early on, there was no supervision or accreditation of these fellowships, and they varied widely in content, structure, and quality. This was widely recognized as being a bad situation for fellow applicants and reflected poorly on the specialties of minimally invasive (MI) and GI surgery. In an effort to bring order to this chaotic situation, the Minimally Invasive Surgery Fellowship Council (MISFC) was founded in 1997.

In 2003, the MISFC was incorporated with 77 founding member programs. The goal of the MISFC was to develop guidelines for high-quality fellowship training, to provide a forum for the directors of MI and GI fellowships to exchange ideas, formulate training curricula; to establish uniform application and selection dates; and to create an equitable computerized match system for applicants.

In 2004, the MISFC has increased to 95 members representing 154 postgraduate fellowship positions. The majority of these positions are primarily laparoscopic in focus, but other aspects of GI surgery including bariatric, general GI, flexible endoscopy, and hepatopancreatobiliary are also represented. Uniform application and selection dates were agreed on in 2001; and in 2003, the Council established a computerized Match, administered by the National Resident Match Program, which was used for the 2004 fellowship selection. A total of 113 positions were open for the match. A total of 248 applicants formally applied to MISFC programs and 130 participated in the match. Ninety-nine positions matched on the December 10th match day, and the remaining 14 programs successfully filled on the following scramble day. Seventeen applicants did not match to a program. Post match polling of program directors and applicants documented a high degree of compliance, usability, and satisfaction with the process.

The MISFC has been successful at realizing its goals of bringing order to the past chaos of the MIS and GI fellowship situation. Its current iteration, the Fellowship Council, is in the process of introducing an accreditation process to further ensure the highest quality of postgraduate training in the fields of GI and endoscopic surgery.