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  1. Home
  3. Awareness And Perceptions Of Flexibility In Surgical Training: Insights From A National Survey Of Surgical Fellowship Program Directors.
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  3. Awareness And Perceptions Of Flexibility In Surgical Training: Insights From A National Survey Of Surgical Fellowship Program Directors.

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Awareness and Perceptions of Flexibility in Surgical Training: Insights From a National Survey of Surgical Fellowship

Steven Tohmasi1, Judith C French2, Darren R Cullinan1

  • 1Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.

Journal of Surgical Education
|October 30, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Fellowship program directors view surgical training flexibility favorably but lack awareness of the Flexibility in Surgical Training (FIST) initiative. Trainees in FIST may possess enhanced subspecialty knowledge and skills.

Keywords:
American Board of Surgeryearly specializationfellowshipflexibilityflexible rotationsgeneral surgeryprogram directorresidencytraining

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Area of Science:

  • Surgical Education
  • Surgical Training Outcomes

Background:

  • The American Board of Surgery (ABS) allows Flexibility in Surgical Training (FIST) for general surgery residents.
  • Prior research indicates FIST is feasible and residents perform well, but postgraduate outcomes are unclear.

Purpose of the Study:

  • To assess awareness and perceptions of FIST among surgical fellowship program directors (PDs).

Main Methods:

  • A cross-sectional electronic survey was sent to PDs of accredited fellowships in various surgical subspecialties.
  • The survey assessed PD attitudes towards FIST, with logistic regression analyzing awareness and perceived educational value.

Main Results:

  • A 34.8% response rate (146 PDs) revealed low awareness of FIST (46.6%) and related literature (63.7%).
  • Only 9.6% of PDs considered FIST participation important for applicants, though 69.9% believed it enhances preparation.
  • PDs perceived FIST participants as having superior technical skills and subspecialty knowledge upon fellowship entry and completion.

    • Conclusions:

    • Fellowship PDs generally support increased flexibility in surgical residency but are largely unaware of the FIST program.
    • While not prioritized in applications, FIST participation may confer advantages in subspecialty knowledge and skills for trainees entering fellowship.