Evaluating Performance and Autonomy Levels of Previous Preliminary Surgery Interns

Area of Science:

• Medical Education
• Surgical Training
• Resident Assessment

Background:

• Nondesignated preliminary year residents gain an extra training year.
• This additional experience may enhance early surgical residency performance.
• Perceptions of preliminary year residents vary.

Purpose of the Study:

• To compare the first-year operative performance of general surgery residents with and without a prior preliminary year.
• To assess differences in faculty- and self-rated experience and autonomy.

Main Methods:

• Operative assessment ratings for first-year general surgery residents (2015-2023) were analyzed.
• Residents were categorized as Previous Prelim (PP) or Traditional Categorical (TC).
• Generalized mixed effects models assessed performance and autonomy outcomes.

Main Results:

• Faculty ratings showed no significant difference in "more experience" (82% PP vs. 76% TC, P=0.26).
• Faculty-rated "some autonomy" was higher for PP residents (88% vs. 80%, P=0.04).
• Self-rated "more experience" (77% PP vs. 50% TC, P=0.01) and "some autonomy" (87% PP vs. 73% TC, P=0.02) were significantly higher for PP residents.

Conclusions:

• First-year general surgery residents who completed a preliminary year demonstrate comparable faculty-assessed operative performance.
• Preliminary year residents report greater self-perceived experience and autonomy in their first year.