Decreasing Resident Vascular Case Volumes Have Not Changed National Numbers of Vascular Fellowship Applications in US General Surgery Residents Over the Past Twenty Years.

Objectives: With an aging workforce and high prevalence of vascular disease, the US is expected to face a pronounced shortage of vascular surgeons over the next 2 decades. This has driven initiatives to expand vascular surgery training positions leading to the rise of integrated residency programs (0 + 5) and the expansion of traditional fellowships (VSFs, 5 + 2). Given the increase in dedicated vascular surgery training positions, there has been a growing concern that general surgery residents (GSRs) are experiencing decreased vascular case volumes.

Scheduling surgical success: Early minimally invasive surgery rotations as a predictor of ABSITE performance.

Introduction: The American Board of Surgery In-Training Examination (ABSITE®) serves as a benchmark for assessing resident knowledge and comprehension in surgery training programs. While previous studies have examined factors such as USMLE Step 1 and Step 2 performance in ABSITE® preparation, the impact of rotational schedule on ABSITE® performance remains underexplored.

Methods: We retrospectively investigated the independent influence of rotational schedule on ABSITE® performance among interns at a single academic institution over an 11 year period.

Non-Designated Preliminary to Categorical Resident: Is It All About the ABSITE?

Introduction: Obtaining a categorical general surgery residency position is recognized as a highly challenging process, and many aspiring surgeons find themselves matching into a preliminary position. The American Board of Surgery In-Training Examination (ABSITE) is relevant as a discriminator, as it is the only national evaluation metric that compares residents between programs. This study examines the correlation between ABSITE performance and the likelihood of obtaining a categorical position for non-designated preliminary surgery residents.

Cutting Ties: General Surgery Residents Have Higher Attrition Rates Than Residents in Other Surgical Training Programs.

Objective: Attrition rates among general surgery residents are notoriously high relative to other specialties. The aim of this study was to compare annual resident attrition rates between general surgery and other surgical subspecialties and to examine these trends in recent years.

Design: This was a retrospective study performed using Accreditation Council for Graduate Medical Education (ACGME) Data Resource Books from 2012-2022.

A scoping review of successful strategies for passing the American Board of Surgery certifying examination.

Background: This scoping review identifies existing literature that investigates what factors contribute to success on the American Board of Surgery (ABS) Certifying Exam (CE) to provide practical, evidence-based recommendations.

Methods: A Pubmed search was completed utilizing the preferred reporting items for systematic reviews and meta-analysis extension for scoping review (PRISMA-ScR) method.

Results: Of 4368 articles identified, 45 articles met criteria for review.

The Role of Artificial Intelligence in Surgery: What do General Surgery Residents Think?

Background: Artificial intelligence (AI) holds significant potential in medical education and patient care, but its rapid emergence presents ethical and practical challenges. This study explored the perspectives of surgical residents on AI's role in medicine.

Methods: We performed a cross-sectional study surveying general surgery residents at a university-affiliated teaching hospital about their views on AI in medicine and surgical training.

What is MIS fellowship? Community and academic program experience.

Introduction: Minimally invasive surgery (MIS) fellowship is one of the most popular fellowship programs, but little is known about the individual fellow's clinical experience. Our goal was to determine the differences in case volume and case type in academic and community programs.

Methods: A retrospective review of advanced gastrointestinal, MIS, foregut, or bariatric fellowship cases logged into the Fellowship Council directory of fellowships during the 2020 and 2021 academic years included for analysis.

Median Arcuate Ligament Syndrome is Effectively Relieved with Minimally Invasive Surgery.

Objective: Median arcuate ligament (MAL) syndrome is a constellation of symptoms related to compression of the celiac artery trunk. Minimally invasive release of the ligament has been shown to improve these symptoms. This study describes one institution's experience with this procedure and reports on outcomes of minimally invasive release and patient quality of life.

Keep it SIMPL: Improved Feedback After Implementation of an App-Based Feedback Tool.

Background: Data defining the utility of the system for improving and measuring procedural learning (SIMPL) in surgical education is limited. The aim of this pilot study is to describe the impact of SIMPL on resident and faculty perspectives regarding operative feedback.

Methods: Residents and faculty were surveyed prior to and 6 months after SIMPL implementation.

What's Nissen on the net? the quality of information regarding Nissen fundoplication on the internet.

Background: More patients are turning to the internet for their health information than ever before. This is a growing problem as it is well recognized that medical information on the internet is highly variable. We assessed the quality of information on the internet regarding the anti-reflux procedure, Nissen Fundoplication.

Assessing Content of Accredited Colon and Rectal Surgery Fellowship Websites: Is there Adequate Information for Applicants?

Electronic information is a vital resource used by fellowship applicants. This study aimed to assess the completeness of colon and rectal surgery (CRS) fellowship program online information. Program information on the Association of Program Directors for Colon and Rectal Surgery (APDCRS) website as well as each institutional website was evaluated based on templated criteria.

Ten Year Trends in Minimally Invasive Surgery Fellowship.

Background: Minimally Invasive Surgery (MIS) is one of the more recently established surgical fellowships, with many candidates applying due to a perception of inadequate exposure to advanced MIS during residency. The desire for advanced training should be reflected in increased competitiveness for fellowship positions. The aim of this study is to determine the desirability of MIS fellowships over time through review of national application data.

Love at First Click: Surgery Residency Websites in the Virtual Era.

Introduction: Frequently, a residency program's website is the first interaction students interested in surgery have with the program. In the setting of virtual interviews for residency in 2020, the online availability of program information is of heightened importance. We sought to assess how academic versus community-based general surgery residency programs compared with respect to certain details on their websites.

An educated guess - Distance estimation by surgeons.

Introduction: Estimating distance is a common task in surgery, yet development of distance estimation ability receives little attention in surgical training. Although the Small bites versus large bites for closure of abdominal midline incisions (STITCH) trial reinforced the importance of suture spacing by demonstrating reduced incisional hernia incidence in placement of 5-mm fascial sutures over 1 cm, we hypothesize that neither trainee nor attending surgeons possess the ability to estimate these distances with accuracy.

Methods: We distributed a 4-question distance estimation exercise and a 6-question survey to resident and attending surgeons at a single academic medical center.

The Rise of Minimally Invasive Surgery: 16 Year Analysis of the Progressive Replacement of Open Surgery with Laparoscopy.

Objective: The expansion of Minimally Invasive Surgery (MIS) has been exponential since the introduction of laparoscopic surgery in the late 1980s. This shift in operative technique has led many to believe that surgery residents are not developing the skills needed to adequately perform open operations.

Methods: We performed a retrospective review of the Accreditation Council for Graduating Medical Education national operative case log database of general surgery residents from January 2003 to December 2019.

Understanding the Well-Being of General Surgery Residents.

Background: In 2017, the Accreditation Council for Graduate Medical Education program guidelines changed to include a section that requires programs to optimize resident and faculty member well-being. There is still a poor understanding of general surgery resident wellness, and there are few well-established wellness programs.

Methods: We created a novel 50-question anonymous survey to assess burnout, depression, and wellness that was distributed to the general surgery residents as part of a pilot study.

USMLE Step 1 Is Pass/Fail - Should the ABSITE Follow Suit?

The United States Medical Licensing Examination (USMLE) Step 1 was recently made pass/fail. This decision was controversial largely because of the reliance on USMLE Step 1 scores in resident selection. However, these scores do not correlate with resident ability.

Small bowel necrosis and perforation due to sodium polystyrene sulfonate in the setting of graft versus host disease and fulminant infection.

Gastrointestinal injury is a common adverse event associated with use of sodium polystyrene sulfonate (SPS), tradename Kayexalate. Risk factors for SPS-mediated gastrointestinal necrosis include chronic kidney disease, solid organ transplant recipiency and recent surgery. This report presents a patient with past medical history significant for acute myeloid leukemia (AML) complicated by graft versus host disease (GvHD) and colitis who initially presented with small bowel obstruction.

A Two-step Technique for Neo-umbilicoplasty in the Abdominal Reconstructive Population.

The umbilicus is the centerpiece of the abdomen and an important cosmetic landmark. Secondary intention healing can be used to create the illusion of an umbilicus in reconstructive surgery. However, there is a sparsity of literature on the role of neo-umbilicoplasty in this subset of patients and how they perceive their new umbilicus.

Insurance Coverage Criteria for Bariatric Surgery: A Survey of Policies.

Background: Bariatric surgery remains underutilized at a national scale, and insurance company reimbursement is an important determinant of access to these procedures. We examined the current state of coverage criteria for bariatric surgery set by private insurance companies.

Methods: We surveyed medical policies of the 64 highest market share health insurance providers in the USA.

Practice Makes Perfect: Introducing a Question Bank for ABSITE Preparation Improves Program Performance.

Background: The American Board of Surgery In-Training Examination (ABSITE) is an important predictor of passing the Qualifying Examination and a determinant of fellowship competitiveness.

Objection: Study the impact of providing program-wide access to a commercially available question bank for ABSITE preparation.

Study Design: The surgery residency program purchased access to the TrueLearn question bank in 2018 A paired sample t test analysis compared the 2018 ABSITE percentage and percentile scores, prior to practice question bank access to 2019 ABSITE percentile scores.