A multi-institutional study from the US ROPE Consortium examining factors associated with directly entering practice...

Area of Science:

• Medical Education
• Surgical Training
• Career Development

Background:

• General surgery graduates' competency is questioned due to increased fellowship pursuits.
• Little is known about residents who enter practice directly after residency.
• Operative experiences may differ between direct-to-practice and fellowship-bound graduates.

Purpose of the Study:

• To compare the operative experiences of general surgery residents who enter practice directly versus those who pursue fellowship.
• To identify factors associated with general surgery residents choosing immediate practice.

Main Methods:

• Analysis of demographics, career choice, and case logs from 1,264 general surgery residents (2010-2020).
• Inclusion of 19 Accreditation Council for Graduate Medical Education-accredited general surgery programs.
• Utilized data from the US Resident OPerative Experience Consortium.

Main Results:

• 19.6% of graduates entered practice directly; 80.4% pursued fellowship.
• Direct-to-practice graduates were more likely to be high-volume residents and from high-volume programs.
• Direct-to-practice residents performed 53 more cases (1,203 vs. 1,150) and had higher chief case volume.

Conclusions:

• This multi-institutional study is the first to explore resident operative experience and career choice.
• Residents aiming for immediate practice can optimize their training by reducing research time and increasing operative volume.
• Findings can inform residency program design for diverse career goals.