The "M" Word: Defining Malignancy in Surgical Residencies

Area of Science:

• Medical Education
• Surgical Training
• Workplace Culture

Background:

• Defining
• malignancy
• is crucial for medical students applying to general surgery residencies.
• Understanding factors contributing to negative residency experiences is essential for improving training environments.

Purpose of the Study:

• To define the term
• malignancy
• within general surgery residency programs.
• To identify key characteristics associated with malignant residency environments.

Main Methods:

• Retrospective qualitative analysis of Reddit.com's General Surgery Match Application spreadsheets.
• Development of a code book for classifying programs as malignant, nonmalignant, or mixed.
• Thematic and pattern analysis of coded data.

Main Results:

• Malignancy is influenced by program factors (duty hours, workload, training, autonomy, hierarchy, benefits) and people factors (toxic culture, teaching quality, resident cohesion).
• Malignant residencies experience decreased applicants, resident attrition, and legal issues.
• Factors contributing to malignancy persist despite duty hour restrictions and abuse reporting systems.

Conclusions:

• General surgery residencies can exhibit
• malignancy
• due to program-wide and individual factors.
• Issues like excessive hours and abuse persist, contributing to negative training environments.
• Addressing these factors is critical for improving resident well-being and program quality.