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3 in 10 Surgery Residents Need Remediation

Cheryl Clark, for HealthLeaders Media, September 18, 2012

California's medical schools may be inadequately preparing future surgeons because a high proportion—nearly one in three— require remediation programs, including having to repeat a year of training, according to a report in the Archives of Surgery.

The research paper finds that 31% of 348 general surgery residents in six California medical schools required additional studies or attendance at conferences or had to repeat a clinical year.

While 15% of the residents in the study cohort were lost to attrition, nearly all left voluntarily, however, and that 15% is somewhat lower than in other studies of surgical residency programs.

"The take-home message is in some respects a positive one in that yes, the rate of remediation is high," says senior author Christian de Virgilio, MD, "but if you look at when this occurred, most residents required it in their first or second year out of five, and by identifying this and putting them in a remediation plan, we were able to successfully get them to graduate. In addition, most of them were able to pass their boards on their first attempt."

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2 comments on "3 in 10 Surgery Residents Need Remediation"


Napoleon Knight (9/20/2012 at 3:36 PM)
I agree with some of the comments, but I think the core issue is that we have cut back the number of hours that residents can care for patients, and not lenghthed the residency programs that they are in. If you simply do teh math, you can see that there likely is not enough time to develop the skills that are needed at the time that they finish their programs. I would suspect if you talked to others across the country, that you would likely hear that in residency programs with a large technical aspect, and even in those that are cognitive in nature, that the new physicians coming out do not seem to be at the same level as in the past. Further restriction of duty hours does not seem to be the issue to me. Ensuring adequate oversight of residents, and having a culture in which help and assistance can be summoned when needed worked well for me as a resident years ago, and I suspect could once again. As the old adage goes, you get what you pay for, and if we are paying for less experiences for those in training, then we should not be surprised out some of the outcomes. Not a great solution for the amazing needs of this great country going forward.

Larry R. Kaiser (9/18/2012 at 11:03 AM)
Harbor-UCLA is not the same as the UCLA School of Medicine that you refer to in your article. The surgery program that De Virgilio heads is separate and distinct from the program at the UCLA Medical Center in Westwood and you fail to make that distinction in your article. I would venture to say that attrition and remediation at the UCLA program (Program Director: O. Joe Hines)likely is not at the level of the other programs (though I don't have the actual data) that form the basis of the article reviewed. That being said the data presented certainly give one cause for concern not just from the actual educational experience provided during the residency but also as to the way that residents are selected. In addition you repeatedly refer to residents as "students' which is confusing. These "students" are graduates of approved medical schools and thus are physicians, albeit in residency programs.