Trimming the fat: optimizing overall educational value by defining factors associated with overall educational value and service-to-education ratio.

Objective: The Accreditation Council for Graduate Medical Education work rules have forced programs to critically appraise the overall educational value (OEV) of rotations. Successful rotations must satisfy Residency Review Committee mandates and optimize the service-to-education ratio (SER). This study was designed to examine the relationship between the OEV and SER and identify rotation characteristics (RC) associated with both.

What is the cost associated with the implementation and maintenance of an ACS/APDS-based surgical skills curriculum?

Purpose: The purpose of this study was to evaluate the cost associated with the American College of Surgery (ACS)/Association of Program Directors in Surgery (APDS)-based surgical skills curriculum (SSC) within a general surgery residency program.

Methods: The Penn Surgical Simulation Center (PSSC) of the University of Pennsylvania was established by the Department of Surgery during the 2006-2007 academic year and became a Level-I ACS Accredited Education Institute in 2008. Each academic year, 38 junior residents are assigned to a 4-week dedicated simulation rotation based on the ACS/APDS-based SSC.

Prevention of surgical resident attrition by a novel selection strategy.

Objective(s): We modified the resident selection strategy in an attempt to reduce resident attrition (RA).

Summary Background Data: Despite implementation of the Accreditation Council for Graduate Medical Education work rules, lifestyle and generational priorities have fostered a persistent and relatively high attrition rate for surgical trainees.

Methods: An independent external review of residents who left the training program and a detailed analysis of the resident selection strategy were performed by an organizational management expert.

Revisiting the rotating call schedule in less than 80 hours per week.

Purpose: The Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions have prompted many surgical training programs to adopt a night-float resident coverage system (NF). Dissatisfaction with NF prompted us to transition to a rotating junior resident call model (Q4) with 24-hour call shifts at the outset of the 2007-2008 academic year. We performed a prospective study to determine the influence of this transition on resident education, morale, and quality of life, as well as on ACGME work rule compliance and American Board of Surgery In-Training Examination (ABSITE) scores.