Analysis of District Residency Program in Surgical Specialties at a University Teaching Hospital

The District Residency Programme (DRP) mandates three-month postings for postgraduate residents in district hospitals across India in various specialties to address healthcare disparities. While the programme demonstrates potential benefits in general medical specialties, its impact on surgical training requires critical evaluation.

This mixed-methods study involved 75 postgraduate surgical residents who completed mandatory DRP postings at a university teaching hospital in India. Data were collected through standardized questionnaires with Likert-scale items and qualitative open-ended questions, analyzed using descriptive statistics and thematic analysis.

Quantitative findings revealed significant limitations in surgical exposure, with 72% of residents reporting limited clinical exposure and 64% experiencing reduced hands-on surgical training during DRP. However, 90% reported enhanced understanding of community healthcare needs, and 80% noted improved patient communication skills. Qualitative analysis identified three key themes: the tension between autonomy and supervision, enhanced community connection, and frustration with resource limitations. While residents valued the increased decision-making autonomy and community engagement, they expressed concerns about inadequate specialist supervision and infrastructure deficiencies impacting surgical skill development.

The DRP significantly contributes to residents' professional identity formation and community health orientation but may compromise specialized surgical training. Recommendations include developing structured surgical curricula for district settings, implementing enhanced supervision models, integrating technology-enhanced learning, improving infrastructure, providing faculty development for district hospital staff, and establishing systematic programme evaluation to optimize the DRP for surgical specialties.