Integrated flexible endoscopy training during surgical residency

Area of Science:

• Gastrointestinal Endoscopy
• Surgical Education
• Medical Training

Background:

• Advances in endoscopic surgery necessitate enhanced skills for future gastrointestinal surgeons.
• Current general surgery residency programs may provide insufficient endoscopy case volume for advanced procedures.
• An evaluation at the University of Missouri showed chief residents averaged only 43 cases, meeting but not exceeding requirements.

Purpose of the Study:

• To assess if dedicating staff surgeon time to a gastrointestinal diagnostic center could improve resident endoscopy case volume.
• To determine the impact of a structured training program on surgical resident endoscopy experience.

Main Methods:

• A retrospective observational review of Accreditation Council for Graduate Medical Education (ACGME) surgery resident case logs from 2001-2005.
• Two staff surgeons dedicated two days per week to an endoscopy center at a Veterans Administration (VA) Hospital.
• Surgical residents participated in endoscopy training days during their VA surgical service rotations.

Main Results:

• Resident endoscopy case volume increased by 850% between 2001 and 2005.
• Graduating residents completed an average of 161 endoscopic procedures.
• Endoscopic experience was distributed across all postgraduate years (PGY-1 to PGY-5).

Conclusions:

• Dedicated endoscopy training days at a VA hospital under staff surgeon guidance effectively increase surgical resident case volume.
• An integrated endoscopy curriculum promotes early skill acquisition and sustained proficiency throughout residency.
• This structured approach facilitates resident integration into research, including natural orifice transluminal endoscopic surgery (NOTES).