Trends in open abdominal exposure among vascular surgery trainees
Victoria Greenwood1, Brian Shames2, Adam Tanious3
1University of Connecticut School of Medicine, Farmington, Conn.
Journal of Vascular Surgery
|June 26, 2017
Summary
The 5+2 vascular surgery pathway provides more open abdominal surgery experience than the integrated vascular surgery residency. However, integrated vascular surgery residents perform more open abdominal aortic aneurysm (AAA) procedures than general surgery residents.
Area of Science:
- Vascular Surgery Training Pathways
- Surgical Education Research
- Graduate Medical Education
Background:
- Evaluating open abdominal surgery case trends in integrated vascular surgery residency (IVSR) versus traditional 5+2 programs.
- Analyzing resident case logs from the Accreditation Council for Graduate Medical Education (ACGME) between 2007 and 2016.
- Comparing training experiences of general surgery residents (GSR), IVSR, and vascular surgery fellows.
Purpose of the Study:
- To compare the open abdominal surgery training experiences of integrated vascular surgery residents (IVSR) with their 5+2 counterparts.
- To assess differences in case volumes and types of open abdominal procedures performed by trainees in different vascular surgery pathways.
- To identify trends in surgical training for open abdominal cases within the United States.
Main Methods:
- Retrospective analysis of ACGME case logs from 9861 residents and fellows across 371 institutions (2007-2016).
- Trainees categorized into general surgery residency (GSR), integrated vascular surgery residency (IVSR), and vascular surgery fellowship.
- Inclusion criteria focused on open abdominal cases involving aorta or adjacent anatomy performed by the chief resident.
Main Results:
- 5+2 graduates had significantly more open vascular surgery training experience than IVSR graduates (P < .01).
- GSR chief residents performed more open abdomen cases than IVSR chief residents (P < .01).
- IVSR chiefs performed more open vascular procedures than GSR chiefs (P < .01).
- 5+2 graduates had greater open abdominal aortic aneurysm (AAA) exposure than IVSR graduates (P < .01).
- IVSR trainees performed more open AAA procedures than GSR counterparts (P < .01).
Conclusions:
- Graduates of the 5+2 vascular training pathway demonstrated significantly higher open abdominal exposure compared to the IVSR track up to 2016.
- Graduates of the IVSR track showed significantly higher open AAA exposure compared to GSR graduates.
- Training pathways influence the type and volume of open abdominal surgery experience gained by vascular surgery trainees.
