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Defining the Surgical Oncology Experience during General Surgery Residency: A Multi-Institutional Study from the US

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Graduates pursuing Complex General Surgical Oncology (CGSO) fellowships log more surgical oncology relevant (SOR) cases during residency. This suggests targeted training may influence career paths and highlights opportunities to enhance recruitment for CGSO programs.

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Area of Science:

  • Surgical Oncology
  • Medical Education
  • Graduate Medical Training

Background:

  • Surgical oncology operative experience during general surgery residency is not well-defined.
  • Hypothesized that Complex General Surgical Oncology (CGSO) fellowship candidates gain more surgical oncology exposure.
  • Surgical Oncology Relevant (SOR) cases logged by residents are a key metric.

Purpose of the Study:

  • To compare the surgical oncology operative experience of general surgery residents who pursue CGSO fellowships versus those who do not.
  • To identify factors associated with matriculation into CGSO fellowships.

Main Methods:

  • Retrospective analysis of Accreditation Council for Graduate Medical Education (ACGME) case logs from 20 general surgery residency programs (2010-2020).
  • Compared CGSO fellowship matriculants (CGSO group) with non-CGSO graduates.
  • Defined SOR cases to include liver, pancreas, breast, endocrine, laparoscopic colorectal, and abdominoperineal resection.

Main Results:

  • CGSO matriculants (6% of graduates) more frequently trained at university-based programs with CGSO faculty and NCI-designated Cancer Centers.
  • CGSO graduates logged significantly more SOR procedures (median 162 vs. 141).
  • Increased SOR cases, departmental NIH funding, and dedicated research experience were associated with CGSO matriculation.

Conclusions:

  • CGSO matriculants exhibit a distinct residency training profile with greater SOR case volume.
  • This increased exposure may prepare residents for fellowship or foster interest in surgical oncology.
  • Findings suggest opportunities to improve CGSO recruitment and fellowship preparation.