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Do General Surgery Residents Begin Specializing Before Fellowship? A Multi-Institutional Study from the US ROPE
Matthew R Woeste1, Christen E Salyer2, Austin C Hammaker2
1From the Department of Surgery, University of Louisville, Louisville, KY (Woeste).
Journal of the American College of Surgeons
|September 14, 2022
Summary
General surgery residents gain more experience in their chosen fellowship specialty during residency. This trend indicates that early specialization begins during residency training, a factor to consider in future residency program redesign.
Area of Science:
- Medical Education
- Surgical Training
- Residency Programs
Background:
- General surgery residents may gain more operative experience in their future subspecialty.
- This study investigated if this trend holds true across multiple residency programs.
Purpose of the Study:
- To determine if general surgery residents gain more fellowship-specific operative experience during residency.
- To analyze operative case logs across different fellowship pathways.
Main Methods:
- Data from 1,192 general surgery residents from 18 ACGME-accredited programs were analyzed.
- Residents were categorized by their chosen fellowship or entry into general surgery practice.
- Operative domains were mapped to fellowships, with comparative analyses performed.
Main Results:
- 80% of residents pursued fellowship, with top choices being trauma/surgical critical care, vascular surgery, and minimally invasive surgery.
- Residents consistently completed more fellowship-specific cases than their peers.
- This association was significant for all 12 fellowships at the chief resident level and 10 at the junior level.
Conclusions:
- General surgery residents gain more operative experience in their chosen subspecialty during residency.
- This suggests specialization begins early in surgical training.
- This finding should inform future redesigns of general surgery residency programs.
