The resident experience on trauma: Declining surgical opportunities and career incentives? analysis of data from a large multi-institutional study Article

Fakhry, SM, Watts, DD, Michetti, C et al. (2003). The resident experience on trauma: Declining surgical opportunities and career incentives? analysis of data from a large multi-institutional study . 54(1), 1-8. 10.1097/00005373-200301000-00001

cited authors

  • Fakhry, SM; Watts, DD; Michetti, C; Hunt, JP; Scalea, T; Cooper, C; Daley, B; Enderson, B; Clancy, KD; Peitzman, AB; Pasquale, MD; Kurek, SJ; Malhotra, AK; Fabian, TC; Wahl, WL; Ahrns, KS; Morken, J; Ney, AL; Liu, TH; Moore, FA; Carrillo, E; Lukan, J; Boulanger, B; Knotts, FB; Shreve, WS; Bilello, JF; Davis, JW; Puente, I; Cohen, SS; Layke, JC; Monk, S; Marburger, R; Bee, T; Pfeifer, WF; Settell, A; Norwood, SH; Vallina, VL; Nichols, PA; Wiles, CE; Jones, LM; Landry, VL; Luchette, FA; Frame, SB; Patterson, LA; Coon, K; Powers, D; Kuzas, A; Jacobs, DG; Sarafin, J; Albuquerque, RG; Yowler, CJ; Farber, MS; Obeid, FN; Salomone, JP; Rozycki, GS; Melton, S; Cross, JM; Haraschak, M; Chang, MC; Koontz, CS; Lynn, M; Frei, LW; Kanne, A; Wang, D; Rhee, P; Mosher, BD; Kam, D; Udekwu, PO; Oller, D; Yuschak, JV; Jubelelirer, RA; Dries, DJ; McGonigal, MD; Oliphant, UJ; Gregory, JS; Gestring, M; Dabrowski, P; Asensio, JA; Forno, W; Roldan, G; Huffman, J; Talucci, R; Welch, G; Esposito, B; Acosta, JA; Rodriguez, P; Buechler, CM; Adams, L; Ashley, DW; Ayoub, M; Chow, S; Suh, K; Fulda, G; Gore, DC; Mileski, WJ; Valenziano, CP; O'Neill, A; Munshi, IA; Kolk, WV; Kemmeter, P

authors

abstract

  • Purpose The surgical resident experience with trauma has changed. Many residents are exposed to predominantly nonoperative patient care experiences while on trauma rotations. Data from a large multicenter study were analyzed to estimate surgical resident exposure to trauma laparotomy, diagnostic peritoneal lavage (DPL), and focused abdominal sonography for trauma (U/S). Methods Centers completed a self-report questionnaire on their institutional demographics, admissions, and procedure for a 2-year period (1998-1999). Results A total of 82 trauma centers that provide resident teaching were included. The included centers represent over 247,000 trauma admissions. The majority of trauma centers (65.9%) had > 80% blunt injury. Although all centers performed laparotomies, other results were more variable. For U/S, 24.2% performed none at all and 47.0% performed fewer than two U/S examinations per month. For DPLs, 3.8% performed none and 66.7% performed fewer than two per month. Assuming 1 night of 4 on call, the average surgical resident training at a trauma center performing > 80% blunt trauma has the potential to participate in only 15 trauma laparotomies, 6 diagnostic peritoneal lavages, and 45 ultrasound examinations per year. In addition, the resident will care for an average of 500 blunt trauma patients before performing a splenectomy or liver repair. Conclusion Surgical resident experience on most trauma services is heavily weighted to nonoperative management, with a relatively low number of procedures, little experience with DPL, and highly variable experience with ultrasound. These data have serious implications for resident training and recruitment into the specialty. © 2003 Lippincott Williams and Wilkins, Inc.

publication date

  • January 1, 2003

Digital Object Identifier (DOI)

start page

  • 1

end page

  • 8

volume

  • 54

issue

  • 1