Resident and faculty expectations for resident PGY performance for laparoscopic cholecystectomy

Area of Science:

• Surgical Education
• Medical Training Assessment

Background:

• Surgical residency aims for competency, but assessment methods are evolving.
• Entrusted Professional Activities (EPAs) are new national standards for assessing surgical resident competency.
• Guidance is lacking on resident autonomy progression in specific surgical procedures like laparoscopic cholecystectomy.

Purpose of the Study:

• To define faculty and resident expectations for resident autonomy progression during laparoscopic cholecystectomy.
• To identify discrepancies in perceived competency timelines between residents and faculty.

Main Methods:

• Anonymous surveys administered to surgical faculty and residents at three institutions.
• Participants indicated the earliest postgraduate year (PGY) they expected residents to achieve competency in seven key laparoscopic cholecystectomy steps.

Main Results:

• General agreement between residents and faculty on competency timelines for most steps.
• Discrepancies noted for cystic duct/artery clipping and gallbladder dissection, with residents expecting earlier competency.
• Median expected PGY for overall laparoscopic cholecystectomy competency was PGY3 for both groups.

Conclusions:

• Residents and faculty generally concur on competency milestones before PGY3 for laparoscopic cholecystectomy.
• Residents anticipate earlier proficiency in critical steps like gallbladder dissection and clipping compared to faculty expectations.