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Career Decisions and the Structure of Training: An American Board of Colon and Rectal Surgery Survey of Colorectal Residents

Schmitz, Constance C. PhD*; Rothenberger, David A. MD*; Trudel, Judith L. MD*; Wolff, Bruce G. MD†

doi: 10.1097/SLA.0b013e3181ad64f1
Original Articles

Objective: To investigate potential impacts of restructuring general surgery training on colorectal (CR) surgery recruitment and expertise.

Summary Background Data: In response to the American Surgical Association Blue Ribbon Committee report on surgical education (2004), the American Board of Colon and Rectal Surgery, working with the Accreditation Council for Graduate Medical Education and American Board of Surgery, established a committee (2006) to review residency training curricula and study new pathways to certification as a CR surgeon. To address concerns related to shortened general surgery residency, the American Board of Colon and Rectal Surgery committee surveyed recent, current, and entering CR residents on the timing and factors associated with their career choice and opinions regarding restructuring.

Methods: A 10-item, online survey of 189 CR surgeons enrolled in the class years of 2005, 2006, and 2007 was administered and analyzed May to July 2007.

Results: One hundred forty-five CR residents responded (77%); results were consistent across class years and types of general surgery training program. Seventy percent of respondents had rotated onto a CR service by the end of their PGY-2 year. Most identified CR as a career interest in their PGY-3 or PGY-4 year. Overall interest in CR surgery, the influence of CR mentors and teachers, and positive exposure to CR as PGY-3, PGY-4, or PGY-5 residents were the top cited factors influencing choice decisions. Respondents were opposed to restructuring by a 2:1 ratio, primarily because of concerns about inadequate training and lack of time to develop technical expertise.

Conclusions: Shortening general surgery residency would not necessarily limit exposure to CR rotations and mentors unless such rotations are cut. The details of proposed restructuring are critical.

In 2004, the American Surgical Association Blue Ribbon Committee recommended that general surgery training be shortened to facilitate earlier specialization. Tasked to study “new pathways of certification,” the American Board of Colon and Rectal Surgery surveyed colorectal residents on the timing and factors associated with their career decision.

From the *Department of Surgery, University of Minnesota, Minneapolis, Minnesota; and †Division of Colon and Rectal Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.

Reprints: Constance C. Schmitz, PhD, Department of Surgery, 11-145 Phillips-Wangensteen Building, 420 Delaware St S.E., MMC 195, University of Minnesota, Minneapolis, MN 55455. E-mail: schmi002@umn.edu.

© 2009 Lippincott Williams & Wilkins, Inc.