Surgical Trainee Familiarity and Knowledge of the Commission on Cancer Operative Standards: A National Survey Study

The Commission on Cancer (CoC) implemented 6 operative standards to reduce technical variation in cancer surgery. Although designed to guide surgeons in performing key oncologic techniques, these standards also provide a framework for teaching high-quality cancer surgery to trainees. We assessed surgical trainees' familiarity with the CoC Operative Standards and the underlying principles of cancer surgery to identify knowledge gaps and opportunities for improved education.

The American College of Surgeons Cancer Surgery Standards Program distributed an anonymous survey to general surgery residents and surgical fellows across the US. Questions addressed the CoC Operative Standards and cancer surgery principles, with scores calculated on the basis of correctness. Univariate logistic regression evaluated associations between trainee or program characteristics and knowledge. Trainees were also asked about their role in procedural documentation, given the synoptic operative report requirements of the standards.

A total of 244 surveys were completed by 205 residents and 39 fellows. Fellows reported greater familiarity with the CoC Operative Standards (68% vs 24%, p < 0.001). Only 30% of trainees reported receiving a formal curriculum on the standards. Correct response rates were 30% for CoC Operative Standards questions vs 50% for cancer surgery principles, with minimal association between knowledge and trainee or program characteristics. Most residents (71%) reported contributing to operative documentation.

Surgical trainees demonstrated limited knowledge of the CoC Operative Standards, highlighting the need for multifaceted educational strategies at the national and institutional levels. Incorporating education about the CoC Operative Standards into surgical training can help emphasize the importance of performing and documenting critical elements of cancer operations.