Protected educational rotations: a valuable paradigm shift in surgical internship.

J Surg Educ

Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA 90095-6904, USA.

Published: March 2009

Objective: The first year of surgical training sometimes includes marginally educational or service-related tasks with limited direct interactions with faculty. We instituted a prototype rotation to address the changing needs and expectations of our intern class. This study was designed to evaluate the new rotation 17 months after it was implemented.

Design: Interns spend 4 weeks in our outpatient surgery center. Elements of the rotation include performance of operative cases and perioperative management of outpatients under direct faculty supervision, daily one-on-one structured teaching sessions with faculty, and call coverage twice monthly. At the conclusion of the rotation, interns make a presentation on a topic of their choosing to a teaching conference. Rotation evaluations and case and work-hour logs for the outpatient surgery rotation (OSR) were compared with those for the remaining intern rotations combined. A faculty survey of the OSR also was conducted.

Results: The OSR consistently received maximum overall ratings (4 of 4), significantly higher than the average overall score for the remaining rotations (3.17, p < 0.01). Similarly, teaching by faculty, time spent in the operating room, and quality of operating room time were rated significantly higher than for the other intern rotations (p
Conclusions: Changing program requirements, time restrictions, public scrutiny, and increasing awareness for quality of life all obligate a paradigm shift in surgical education. Our outpatient rotation is logistically simple and rewarding both for residents and faculty.

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http://dx.doi.org/10.1016/j.jsurg.2008.07.012DOI Listing

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