TY - JOUR
T1 - A multi-institutional study from the US ROPE Consortium examining factors associated with directly entering practice upon residency graduation
AU - Hammaker, Austin C.
AU - Dodwad, Shah Jahan M.
AU - Salyer, Christen E.
AU - Adams, Sasha D.
AU - Foote, Darci C.
AU - Ivascu, Felicia A.
AU - Kader, Sarah
AU - Abelson, Jonathan S.
AU - Al Yafi, Motaz
AU - Sutton, Jeffrey M.
AU - Smith, Savannah
AU - Postlewait, Lauren M.
AU - Stopenski, Stephen J.
AU - Nahmias, Jeffry T.
AU - Harvey, Jalen
AU - Farr, Deborah
AU - Callahan, Zachary M.
AU - Marks, Joshua A.
AU - Elsaadi, Ali
AU - Campbell, Samuel J.
AU - Stahl, Christopher C.
AU - Hanseman, Dennis J.
AU - Patel, Purvi
AU - Woeste, Matthew R.
AU - Martin, Robert C.G.
AU - Patel, Jitesh A.
AU - Newcomb, Melissa R.
AU - Greenwell, Kathriena
AU - Meister, Katherine M.
AU - Etheridge, James C.
AU - Cho, Nancy L.
AU - Thrush, Carol R.
AU - Kimbrough, Mary K.
AU - Nasim, Bilal Waqar
AU - Willis, Ross E.
AU - George, Brian C.
AU - Quillin, Ralph C.
AU - Cortez, Alexander R.
N1 - Funding Information:
The US Resident OPerative Experience (ROPE) Consortium is a multi-institutional collaboration of 19 ACGME-accredited US general surgery residency programs formed to explore the operative experience of general surgery residents. Case log reports were collected for all graduates of these programs from 2010 to 2020. In addition to the case logs, resident and program factors were collected. Resident factors included age, sex (self-reported), graduation year, race/ethnicity (Asian, Black, Hispanic, White, and Other), location of the medical school (US graduate or international medical graduate [IMG]), the completion of a dedicated research experience during residency, resident volume, and career choice. Graduates were categorized as low-, medium-, or high-volume based on their tertile of total operative volume among all graduates in the cohort. Career choice was provided by each program and categorized as either entered directly into practice or pursued fellowship (within 2 years of graduation). Program factors included program region (Midwest, Northeast, Southeast, Southwest, West), program volume, program size, and National Institutes of Health (NIH) funding status. Program volume was categorized as low, medium, or high based on the tertile of the program’s average operative volume per graduate within the entire cohort. Program size was defined based on the distribution of program average yearly graduates in the dataset, categorized as small (<5 average graduates per year), medium (5–6 average graduates per year), or large (≥7 average graduates per year). NIH funding status for each program was obtained from the Research Portfolio Online Reporting Tool (RePORT), which provides a list of NIH-funded surgery programs in the US, and programs were categorized as being within the top 50, bottom 50, or none (nonfunded). 19
Funding Information:
No funding or financial support was provided for this project.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/9
Y1 - 2022/9
N2 - Background: There is concern regarding the competency of today's general surgery graduates as a large proportion defer independent practice in favor of additional fellowship training. Little is known about the graduates who directly enter general surgery practice and if their operative experiences during residency differ from graduates who pursue fellowship. Methods: Nineteen Accreditation Council for Graduate Medical Education–accredited general surgery programs from the US Resident OPerative Experience Consortium were included. Demographics, career choice, and case logs from graduates between 2010 to 2020 were analyzed. Results: There were 1,264 general surgery residents who graduated over the 11-year period. A total of 248 (19.6%) went directly into practice and 1,016 (80.4%) pursued fellowship. Graduates directly entering practice were more likely to be a high-volume resident (43.1% vs 30.5%, P < .01) and graduate from a high-volume program (49.2% vs 33.0%, P < .01). Direct-to-practice graduates performed 53 more cases compared with fellowship-bound graduates (1,203 vs 1,150, P < .01). On multivariable analysis, entering directly into practice was positively associated with total surgeon chief case volume (odds ratio = 1.47, 95% confidence interval 1.18–1.84, P < .01) and graduating from a US medical school (odds ratio = 2.54, 95% confidence interval 1.45–4.44, P < .01) while negatively associated with completing a dedicated research experience (odds ratio = 0.31, 95% confidence interval 0.22–0.45, P < .01). Conclusion: This is the first multi-institutional study exploring resident operative experience and career choice. These data suggest residents who desire immediate practice can tailor their experience with less research time and increased operative volume. These data may be helpful for programs when designing their experience for residents with different career goals.
AB - Background: There is concern regarding the competency of today's general surgery graduates as a large proportion defer independent practice in favor of additional fellowship training. Little is known about the graduates who directly enter general surgery practice and if their operative experiences during residency differ from graduates who pursue fellowship. Methods: Nineteen Accreditation Council for Graduate Medical Education–accredited general surgery programs from the US Resident OPerative Experience Consortium were included. Demographics, career choice, and case logs from graduates between 2010 to 2020 were analyzed. Results: There were 1,264 general surgery residents who graduated over the 11-year period. A total of 248 (19.6%) went directly into practice and 1,016 (80.4%) pursued fellowship. Graduates directly entering practice were more likely to be a high-volume resident (43.1% vs 30.5%, P < .01) and graduate from a high-volume program (49.2% vs 33.0%, P < .01). Direct-to-practice graduates performed 53 more cases compared with fellowship-bound graduates (1,203 vs 1,150, P < .01). On multivariable analysis, entering directly into practice was positively associated with total surgeon chief case volume (odds ratio = 1.47, 95% confidence interval 1.18–1.84, P < .01) and graduating from a US medical school (odds ratio = 2.54, 95% confidence interval 1.45–4.44, P < .01) while negatively associated with completing a dedicated research experience (odds ratio = 0.31, 95% confidence interval 0.22–0.45, P < .01). Conclusion: This is the first multi-institutional study exploring resident operative experience and career choice. These data suggest residents who desire immediate practice can tailor their experience with less research time and increased operative volume. These data may be helpful for programs when designing their experience for residents with different career goals.
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U2 - 10.1016/j.surg.2022.05.033
DO - 10.1016/j.surg.2022.05.033
M3 - Article
C2 - 35788283
AN - SCOPUS:85133380610
SN - 0039-6060
VL - 172
SP - 906
EP - 912
JO - Surgery (United States)
JF - Surgery (United States)
IS - 3
ER -