Effect of structuring clinical services based on resident educational objectives.

Area of Science:

• Medical Education
• Surgical Training
• Healthcare Management

Background:

• Traditional surgical rotations are structured around attending surgeon specialty and department organization.
• This structure may not align with the educational needs of surgical residents.
• Realigning clinical services based on resident educational objectives offers an alternative approach.

Purpose of the Study:

• To evaluate the effects of reorganizing clinical services based on resident educational objectives.
• To assess impacts on resident education, clinical referral patterns, and faculty patient volumes.

Main Methods:

• A comprehensive reorganization of clinical service lines prioritizing resident educational objectives.
• Qualitative evaluation of resident education via semistructured interviews.
• Assessment of clinical referral patterns and faculty patient volumes.

Main Results:

• New rotations were designed, including hepatobiliary/transplant, acute care surgery, and minimally invasive surgery.
• All residents met minimum case number requirements before postgraduate year 5.
• Key improvements observed in American Board of Surgery In-Training Examination scores and total resident operative cases.
• Increased individual faculty clinical volume and coordinated multidisciplinary clinical services.

Conclusions:

• Reorganization based on resident goals can measurably improve education without disrupting faculty practices.
• Unanticipated benefits include new collaborative opportunities for faculty across traditional barriers.
• This process enables rapid educational change, requiring faculty cooperation and a willingness to adapt traditional service organization.