What is MIS fellowship? Community and academic program experience

Area of Science:

• Surgical Education
• Minimally Invasive Surgery
• Fellowship Training

Background:

• Minimally invasive surgery (MIS) fellowship is a popular postgraduate training pathway.
• There is limited understanding of the clinical experience variation among MIS fellows.
• Differences in case volume and type between academic and community fellowship programs are not well-defined.

Purpose of the Study:

• To compare case volumes and types experienced by fellows in academic versus community MIS programs.
• To identify potential disparities in surgical training across different practice settings.

Main Methods:

• Retrospective review of fellowship cases logged in the Fellowship Council directory (2020-2021).
• Analysis included 57,324 cases from 58 academic and 62 community programs.
• Student's t-test was used for statistical comparisons between groups.

Main Results:

• Overall case volume per fellow was similar between academic (462.5 cases) and community (491.9 cases) programs.
• No significant differences in common procedures like bariatric surgery, endoscopy, hernia, and foregut surgery.
• Community programs showed significantly higher case volumes in less common procedures (appendix, colon, HPB, peritoneum, small bowel).

Conclusions:

• MIS fellowship training provides comparable experience in high-volume, common procedures regardless of setting.
• Community-based programs offer broader exposure to less frequently performed MIS procedures.
• Substantial variability exists in MIS fellowship operative experience, warranting further investigation into training quality.