Abstract
Purpose The surgical resident experience with trauma has changed. Many residents are exposed to predominantly nonoperative patient care experiences while on trauma rotations. Data from a large multicenter study were analyzed to estimate surgical resident exposure to trauma laparotomy, diagnostic peritoneal lavage (DPL), and focused abdominal sonography for trauma (U/S). Methods Centers completed a self-report questionnaire on their institutional demographics, admissions, and procedure for a 2-year period (1998-1999). Results A total of 82 trauma centers that provide resident teaching were included. The included centers represent over 247,000 trauma admissions. The majority of trauma centers (65.9%) had > 80% blunt injury. Although all centers performed laparotomies, other results were more variable. For U/S, 24.2% performed none at all and 47.0% performed fewer than two U/S examinations per month. For DPLs, 3.8% performed none and 66.7% performed fewer than two per month. Assuming 1 night of 4 on call, the average surgical resident training at a trauma center performing > 80% blunt trauma has the potential to participate in only 15 trauma laparotomies, 6 diagnostic peritoneal lavages, and 45 ultrasound examinations per year. In addition, the resident will care for an average of 500 blunt trauma patients before performing a splenectomy or liver repair. Conclusion Surgical resident experience on most trauma services is heavily weighted to nonoperative management, with a relatively low number of procedures, little experience with DPL, and highly variable experience with ultrasound. These data have serious implications for resident training and recruitment into the specialty.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | Journal of Trauma |
| Volume | 54 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2003 |
Keywords
- Operative experience
- Operative procedures
- Surgical resident education, andNA
- Surgical training
- Trauma, Career choices
ASJC Scopus subject areas
- Surgery
- Critical Care and Intensive Care Medicine
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The resident experience on trauma : Declining surgical opportunities and career incentives? analysis of data from a large multi-institutional study. / Fakhry, Samir M.; Watts, Dorraine D.; Michetti, Christopher; Hunt, John P.; Scalea, Thomas; Cooper, Carnell; Daley, Brian; Enderson, Blaine; Clancy, Keith D.; Peitzman, Andrew B.; Pasquale, Michael D.; Kurek, Stanley J.; Malhotra, Ajai K.; Fabian, Timothy C.; Wahl, Wendy L.; Ahrns, Karla S.; Morken, Jeffrey; Ney, Arthur L.; Liu, Terrence H.; Moore, Frederick A.; Carrillo, Eddy; Lukan, James; Boulanger, Bernard; Knotts, F. Barry; Shreve, Wendy Sue; Bilello, John F.; Davis, James W.; Puente, Ivan; Cohen, Sharon S.; Layke, John C.; Monk, Scott; Marburger, Robert; Bee, Tiffany; Pfeifer, William F.; Settell, April; Norwood, Scott H.; Vallina, Van L.; Nichols, Pamela A.; Wiles, Charles E.; Jones, Larry M.; Landry, Victor L.; Luchette, Fred A.; Frame, Scott B.; Patterson, Lisa A.; Coon, Kathy; Powers, Daniel; Kuzas, Anne; Jacobs, David G.; Sarafin, Jennifer; Albuquerque, Ronald G.; Yowler, Charles J.; Farber, Mitchell Scott; Obeid, Farouck N.; Salomone, Jeffrey P.; Rozycki, Grace S.; Melton, Sherry; Cross, James M.; Haraschak, Michael; Chang, Michael C.; Koontz, Curt S.; Lynn, Mauricio; Frei, Lonnie W.; Kanne, Antoinette; Wang, Dennis; Rhee, Peter; Mosher, Benjamin D.; Kam, David; Udekwu, Pascal O.; Oller, Dale; Yuschak, James V.; Jubelelirer, Robert A.; Dries, David J.; McGonigal, Michael D.; Oliphant, Uretz J.; Gregory, James S.; Gestring, Mark; Dabrowski, Paul; Asensio, Juan A.; Forno, Walter; Roldan, Gustavo; Huffman, Joan; Talucci, Raymond; Welch, Gary; Esposito, Barbara; Acosta, Jose A.; Rodriguez, Pablo; Buechler, C. M.; Adams, Leanne; Ashley, Dennis W.; Ayoub, Macram; Chow, Stuart; Suh, Kwang; Fulda, Gerard; Gore, Dennis C.; Mileski, William J.; Valenziano, Carl P.; O'Neill, Anne; Munshi, Imtiaz A.; Kolk, Wayne Vander; Kemmeter, Paul; Walsh, Jon; Myers, Mary B.; Kaplan, Lewis J.; Santora, Thomas; Johnson, Judith; Griner, Paula; Patel, Nirav; Cogbill, Thomas; Rotondo, Michael F.; Sagraves, Scott G.; Cullinane, Daniel C.; Schrage, Susan; Kerwin, Andrew J.; Bynoe, Raymond P.; Lottenberg, Lawrence; Holtzman, Robert; Bennett-Shipman, Vicki J.; Schurr, Michael; Newton, Monica; Rosen, Jeffery; Salvino, Christopher; Bankey, Paul; Norkiewicz, Brian J.; Cherry, Robert A.; Enriquez, Eliza; Peschiera, Juan L.; Johnson, W. Michael; Holcomb, John B.; Dumire, Russell; Hall, John R.; Testerman, George M.; Jenkins, Donald H.; Josephs, John D.; Wohltmann, Christopher; Raimonde, A. Jay; Dalton, Arthur B.; Weireter, Leonard J.; Cole, Frederic J.; Marx, William; Sposato, Emily M.; Pomerantz, Richard; Sharma, Om P.; Oswanshi, Michael; Bokhari, Faran; Nagy, Kimberly; Fallat, Mary E.; Hardwick-Barnes, Vicki; Baker, Deborah; Phillips, Judith; Fishman, Don R.; Park, Pauline; Cohen, Murray; Wright, Mary Jo; Hunt, John; Moncure, Michael; Strickler, Jeff; Bonadies, John A.; O'Connor, Judith A.; Sutton, John E.; Corcoran, Eileen; Rogers, Frederick B.; Kohn, Jonathan; Dove, Dennis B.; Galvan, Dan A.; O’hara, Kathleen P.; Schmidt, Hans Joseph; Pachter, Leon; Grau, Juan; LaVorgna, Kathleen A.; Dineen, J. P.; Staib, Sheila; Diamelio, L. F.; Buchro, Sharon; Dietz, Patrick A.; Higgins, Diane; Perez, J. Martin; Brathwaite, Collin E.M.; Butler, Karyn; Sinclair, Karlene; Siram, S. M.; Seoudi, Hani.
In: Journal of Trauma, Vol. 54, No. 1, 01.2003, p. 1-8.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - The resident experience on trauma
T2 - Declining surgical opportunities and career incentives? analysis of data from a large multi-institutional study
AU - Fakhry, Samir M.
AU - Watts, Dorraine D.
AU - Michetti, Christopher
AU - Hunt, John P.
AU - Scalea, Thomas
AU - Cooper, Carnell
AU - Daley, Brian
AU - Enderson, Blaine
AU - Clancy, Keith D.
AU - Peitzman, Andrew B.
AU - Pasquale, Michael D.
AU - Kurek, Stanley J.
AU - Malhotra, Ajai K.
AU - Fabian, Timothy C.
AU - Wahl, Wendy L.
AU - Ahrns, Karla S.
AU - Morken, Jeffrey
AU - Ney, Arthur L.
AU - Liu, Terrence H.
AU - Moore, Frederick A.
AU - Carrillo, Eddy
AU - Lukan, James
AU - Boulanger, Bernard
AU - Knotts, F. Barry
AU - Shreve, Wendy Sue
AU - Bilello, John F.
AU - Davis, James W.
AU - Puente, Ivan
AU - Cohen, Sharon S.
AU - Layke, John C.
AU - Monk, Scott
AU - Marburger, Robert
AU - Bee, Tiffany
AU - Pfeifer, William F.
AU - Settell, April
AU - Norwood, Scott H.
AU - Vallina, Van L.
AU - Nichols, Pamela A.
AU - Wiles, Charles E.
AU - Jones, Larry M.
AU - Landry, Victor L.
AU - Luchette, Fred A.
AU - Frame, Scott B.
AU - Patterson, Lisa A.
AU - Coon, Kathy
AU - Powers, Daniel
AU - Kuzas, Anne
AU - Jacobs, David G.
AU - Sarafin, Jennifer
AU - Albuquerque, Ronald G.
AU - Yowler, Charles J.
AU - Farber, Mitchell Scott
AU - Obeid, Farouck N.
AU - Salomone, Jeffrey P.
AU - Rozycki, Grace S.
AU - Melton, Sherry
AU - Cross, James M.
AU - Haraschak, Michael
AU - Chang, Michael C.
AU - Koontz, Curt S.
AU - Lynn, Mauricio
AU - Frei, Lonnie W.
AU - Kanne, Antoinette
AU - Wang, Dennis
AU - Rhee, Peter
AU - Mosher, Benjamin D.
AU - Kam, David
AU - Udekwu, Pascal O.
AU - Oller, Dale
AU - Yuschak, James V.
AU - Jubelelirer, Robert A.
AU - Dries, David J.
AU - McGonigal, Michael D.
AU - Oliphant, Uretz J.
AU - Gregory, James S.
AU - Gestring, Mark
AU - Dabrowski, Paul
AU - Asensio, Juan A.
AU - Forno, Walter
AU - Roldan, Gustavo
AU - Huffman, Joan
AU - Talucci, Raymond
AU - Welch, Gary
AU - Esposito, Barbara
AU - Acosta, Jose A.
AU - Rodriguez, Pablo
AU - Buechler, C. M.
AU - Adams, Leanne
AU - Ashley, Dennis W.
AU - Ayoub, Macram
AU - Chow, Stuart
AU - Suh, Kwang
AU - Fulda, Gerard
AU - Gore, Dennis C.
AU - Mileski, William J.
AU - Valenziano, Carl P.
AU - O'Neill, Anne
AU - Munshi, Imtiaz A.
AU - Kolk, Wayne Vander
AU - Kemmeter, Paul
AU - Walsh, Jon
AU - Myers, Mary B.
AU - Kaplan, Lewis J.
AU - Santora, Thomas
AU - Johnson, Judith
AU - Griner, Paula
AU - Patel, Nirav
AU - Cogbill, Thomas
AU - Rotondo, Michael F.
AU - Sagraves, Scott G.
AU - Cullinane, Daniel C.
AU - Schrage, Susan
AU - Kerwin, Andrew J.
AU - Bynoe, Raymond P.
AU - Lottenberg, Lawrence
AU - Holtzman, Robert
AU - Bennett-Shipman, Vicki J.
AU - Schurr, Michael
AU - Newton, Monica
AU - Rosen, Jeffery
AU - Salvino, Christopher
AU - Bankey, Paul
AU - Norkiewicz, Brian J.
AU - Cherry, Robert A.
AU - Enriquez, Eliza
AU - Peschiera, Juan L.
AU - Johnson, W. Michael
AU - Holcomb, John B.
AU - Dumire, Russell
AU - Hall, John R.
AU - Testerman, George M.
AU - Jenkins, Donald H.
AU - Josephs, John D.
AU - Wohltmann, Christopher
AU - Raimonde, A. Jay
AU - Dalton, Arthur B.
AU - Weireter, Leonard J.
AU - Cole, Frederic J.
AU - Marx, William
AU - Sposato, Emily M.
AU - Pomerantz, Richard
AU - Sharma, Om P.
AU - Oswanshi, Michael
AU - Bokhari, Faran
AU - Nagy, Kimberly
AU - Fallat, Mary E.
AU - Hardwick-Barnes, Vicki
AU - Baker, Deborah
AU - Phillips, Judith
AU - Fishman, Don R.
AU - Park, Pauline
AU - Cohen, Murray
AU - Wright, Mary Jo
AU - Hunt, John
AU - Moncure, Michael
AU - Strickler, Jeff
AU - Bonadies, John A.
AU - O'Connor, Judith A.
AU - Sutton, John E.
AU - Corcoran, Eileen
AU - Rogers, Frederick B.
AU - Kohn, Jonathan
AU - Dove, Dennis B.
AU - Galvan, Dan A.
AU - O’hara, Kathleen P.
AU - Schmidt, Hans Joseph
AU - Pachter, Leon
AU - Grau, Juan
AU - LaVorgna, Kathleen A.
AU - Dineen, J. P.
AU - Staib, Sheila
AU - Diamelio, L. F.
AU - Buchro, Sharon
AU - Dietz, Patrick A.
AU - Higgins, Diane
AU - Perez, J. Martin
AU - Brathwaite, Collin E.M.
AU - Butler, Karyn
AU - Sinclair, Karlene
AU - Siram, S. M.
AU - Seoudi, Hani
PY - 2003/1
Y1 - 2003/1
N2 - Purpose The surgical resident experience with trauma has changed. Many residents are exposed to predominantly nonoperative patient care experiences while on trauma rotations. Data from a large multicenter study were analyzed to estimate surgical resident exposure to trauma laparotomy, diagnostic peritoneal lavage (DPL), and focused abdominal sonography for trauma (U/S). Methods Centers completed a self-report questionnaire on their institutional demographics, admissions, and procedure for a 2-year period (1998-1999). Results A total of 82 trauma centers that provide resident teaching were included. The included centers represent over 247,000 trauma admissions. The majority of trauma centers (65.9%) had > 80% blunt injury. Although all centers performed laparotomies, other results were more variable. For U/S, 24.2% performed none at all and 47.0% performed fewer than two U/S examinations per month. For DPLs, 3.8% performed none and 66.7% performed fewer than two per month. Assuming 1 night of 4 on call, the average surgical resident training at a trauma center performing > 80% blunt trauma has the potential to participate in only 15 trauma laparotomies, 6 diagnostic peritoneal lavages, and 45 ultrasound examinations per year. In addition, the resident will care for an average of 500 blunt trauma patients before performing a splenectomy or liver repair. Conclusion Surgical resident experience on most trauma services is heavily weighted to nonoperative management, with a relatively low number of procedures, little experience with DPL, and highly variable experience with ultrasound. These data have serious implications for resident training and recruitment into the specialty.
AB - Purpose The surgical resident experience with trauma has changed. Many residents are exposed to predominantly nonoperative patient care experiences while on trauma rotations. Data from a large multicenter study were analyzed to estimate surgical resident exposure to trauma laparotomy, diagnostic peritoneal lavage (DPL), and focused abdominal sonography for trauma (U/S). Methods Centers completed a self-report questionnaire on their institutional demographics, admissions, and procedure for a 2-year period (1998-1999). Results A total of 82 trauma centers that provide resident teaching were included. The included centers represent over 247,000 trauma admissions. The majority of trauma centers (65.9%) had > 80% blunt injury. Although all centers performed laparotomies, other results were more variable. For U/S, 24.2% performed none at all and 47.0% performed fewer than two U/S examinations per month. For DPLs, 3.8% performed none and 66.7% performed fewer than two per month. Assuming 1 night of 4 on call, the average surgical resident training at a trauma center performing > 80% blunt trauma has the potential to participate in only 15 trauma laparotomies, 6 diagnostic peritoneal lavages, and 45 ultrasound examinations per year. In addition, the resident will care for an average of 500 blunt trauma patients before performing a splenectomy or liver repair. Conclusion Surgical resident experience on most trauma services is heavily weighted to nonoperative management, with a relatively low number of procedures, little experience with DPL, and highly variable experience with ultrasound. These data have serious implications for resident training and recruitment into the specialty.
KW - Operative experience
KW - Operative procedures
KW - Surgical resident education, andNA
KW - Surgical training
KW - Trauma, Career choices
UR - http://www.scopus.com/inward/record.url?scp=0037242664&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037242664&partnerID=8YFLogxK
U2 - 10.1097/00005373-200301000-00001
DO - 10.1097/00005373-200301000-00001
M3 - Article
C2 - 12544893
AN - SCOPUS:0037242664
VL - 54
SP - 1
EP - 8
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 1
ER -