Colorectal Cancer and Quality of Life: A Medicare Advantage Study by Race, Ethnicity, and Language.

Background And Methods: Colorectal cancer (CRC) treatment can influence health-related quality of life (HRQOL). This study examined HRQOL among older adults undergoing CRC treatment, and the conditional effects of race, ethnicity, and primary language. We conducted a retrospective cohort study of Medicare Advantage enrollees ≥ 65 years old who completed the Medicare Health Outcomes Survey (MHOS) (2016-2020).

Gender gap in surgical societies awards.

Introduction: Despite remarkable progress, gender inequality in medicine remains a significant issue. This disparity extends beyond clinical practices and educational programs; it is also evident in the recognition and awards received by surgeons. Underrepresentation of women in Surgical Society awards is a multi-layered issue that needs a holistic approach since these awards are used to hire, promote, and advance surgeons.

Trends in general surgeon operative practice patterns in a modern cohort.

Introduction: Analyzing general surgeons' operative case mix can provide an update on contemporary practice patterns and inform pragmatic residency training.

Methods: We performed a retrospective cohort study of general surgeons in Florida, Iowa, and Maryland, 2016-2020. Cases were identified using billing codes.

Gastrointestinal surgery, malabsorptive conditions, and postoperative hypocalcemia after neck surgery.

Background: Postoperative hypocalcemia is a common complication of thyroid and parathyroid surgery. Patients with prior gastric bypass face increased risk of postoperative hypocalcemia, but the impact of other malabsorptive conditions is not well understood. In this study, we evaluated the relationship between multiple medical and surgical malabsorptive states and hypocalcemia after thyroid and parathyroid surgery.

Telemedicine and Access to Elective Cholecystectomy for Socially Vulnerable Adults: A Pilot Randomized Clinical Trial.

Importance: Socially vulnerable patients with symptomatic cholelithiasis are more likely to face barriers to accessing surgical care. This barrier to access can lead to delays in treatment, the need for emergent cholecystectomy, and worse outcomes.

Objectives: To determine the effectiveness of telemedicine vs in-person surgical consultation on access to elective cholecystectomy in socially vulnerable populations and to evaluate the association of scheduling navigation with access to elective cholecystectomy in these populations.

Resident Self-Efficacy in Grantsmanship Lags Behind Key Funding Deadlines.

Purpose: Extramural funding is critical to career success and advancement in academic surgery, and surgical residents can apply for both societal and federal funding. Many federal funding mechanisms require proposals to be submitted before residents' formal research years.

Methods: To better understand the resident experience with grantsmanship, we distributed a validated grantsmanship self-efficacy assessment inventory for voluntary completion at our academic general surgery training program with 2 years of dedicated research.

Post Night Shift Education for Interns: A Pilot Program.

Background: Night float rotations are associated with decreased feedback, educational conference attendance, and operative time. Interns are also more isolated and spend less time on teams. We therefore developed a novel post night shift initiative to address these shortcomings and examined its impact on the educational experience and sense of belonging among interns.

Minimally invasive colorectal cancer surgery: an observational study of medicare advantage and fee-for-service beneficiaries.

Background: Enrollment of Medicare beneficiaries in medicare advantage (MA) plans has been steadily increasing. Prior research has shown differences in healthcare access and outcomes based on Medicare enrollment status. This study sought to compare utilization of minimally invasive colorectal cancer (CRC) surgery and postoperative outcomes between MA and Fee-for-Service (FFS) beneficiaries.

The Predictive Performance of General Surgery Milestones on Post-Graduation Outcomes.

Objective: To establish whether Accreditation Council for Graduate Medical Education Milestones predict future performance of general surgery trainees.

Summary Background Data: Milestones provide bi-annual assessments of trainee progress across six competencies. It is unknown whether the Milestones predict surgeon performance after the transition to independent practice.

Key Issues in Surgical Residency Education: Recommendations of the Blue Ribbon II Committee Residency Education Subcommittee.

Background: In September 2022, a summit was convened by the American Board of Surgery (ABS) to discuss competency-based reform in surgical education. A key output of that summit was the recommendation that the prior work of the Blue Ribbon I Committee convened 20 years earlier be revived. With leadership from the American College of Surgeons (ACS) and the American Surgical Association (ASA), the Blue Ribbon Committee (BRC) II was subsequently convened.

Revisiting the Relationship Between Tumor Size and Risk in Well-Differentiated Thyroid Cancer.

Large tumor size is associated with poorer outcomes in well-differentiated thyroid cancer, yet it remains unclear whether size >4 cm alone confers increased risk, independent of other markers of aggressive disease. The goal of this study was to assess the relationship between tumor size, other high-risk histopathological features, and survival in well-differentiated thyroid cancer and to evaluate the significance of 4 cm as a cutoff for management decisions. Patients with well-differentiated thyroid cancer were identified from the National Cancer Database (2010-2015) and categorized by tumor size (i.

Surgeon and Surgical Trainee Experiences After Adverse Patient Events.

Importance: Adverse patient events are inevitable in surgical practice.

Objectives: To characterize the impact of adverse patient events on surgeons and trainees, identify coping mechanisms, and assess whether current forms of support are sufficient.

Design, Setting, And Participants: In this mixed-methods study, a validated survey instrument was adapted and distributed to surgical trainees from 7 programs, and qualitative interviews were conducted with faculty from 4 surgical departments in an urban academic health system.

The influence of primary language on postoperative stroke outcomes.

Background: Language barriers have the potential to influence acute stroke outcomes. Thus, we examined postoperative stroke outcomes among non-English primary language speakers.

Methods: Utilizing the Healthcare Cost and Utilization Project State Inpatient Database (2016-2019), we conducted a retrospective cohort study of adults diagnosed with a postoperative stroke in Michigan, Maryland, and New Jersey.

Post-discharge Mental Healthcare and Emergency General Surgery Readmission for Patients with Serious Mental Illness.

Objective: To determine the association between post-discharge mental healthcare and odds of readmission after emergency general surgery (EGS) hospitalization for patients with serious mental illness (SMI).

Background Data: A mental health visit (MHV) after medical hospitalization is associated with decreased readmissions for patients with SMI. The impact of a MHV after surgical hospitalization is unknown.

Should I See You Again Soon? Multispecialty Assessment of Impact and Burden of Preoperative History and Physical Update Visits.

Background: Federal regulations require a history and physical (H&P) update performed 30 days or less before a planned procedure. We evaluated the use and burdens of H&P update visits by determining impact on operative management, suitability for telehealth, and visit time and travel burden.

Study Design: We identified H&P update visits performed in our health system during 2019 for 8 surgical specialties.

Impact of Hospital Affiliation With a Flagship Hospital System on Surgical Outcomes.

Objective: To compare general surgery outcomes at flagship systems, flagship hospitals, and flagship hospital affiliates versus matched controls.

Summary Background Data: It is unknown whether flagship hospitals perform better than flagship hospital affiliates for surgical patients.

Methods: Using Medicare claims for 2018 to 2019, we matched patients undergoing inpatient general surgery in flagship system hospitals to controls who underwent the same procedure at hospitals outside the system but within the same region.

Sex differences and racial/ethnic disparities in the presentation and treatment of medullary thyroid cancer.

Background: This study assessed for disparities in the presentation and management of medullary thyroid cancer (MTC).

Methods: Patients with MTC (2010-2020) were identified from the National Cancer Database. Differences in disease presentation and likelihood of guideline-concordant surgical management (total thyroidectomy and resection of ≥1 lymph node) were assessed by sex and race/ethnicity.

Belonging in Surgery: A Validated Instrument and Single Institutional Pilot.

Objective: The aim of this study was to develop and validate an instrument to measure Belonging in Surgery among surgical residents.

Background: Belonging is the essential human need to maintain meaningful relationships and connections to one's community. Increased belongingness is associated with better well-being, job performance, and motivation to learn.

Modern Trends for Primary Hyperparathyroidism: Intervening on Less Biochemically Severe Disease.

Introduction: Primary hyperparathyroidism (PHPT) is defined by autonomous parathyroid hormone secretion, which has broad physiologic effects. Parathyroidectomy is the only cure and is recommended for patients demonstrating symptomatic disease and/or end organ damage. However, there may be a benefit to intervening before the development of complications.