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Remediation & Attrition in General Surgery Residents

Remediation & Attrition in General Surgery Residents

The Accreditation Council for Graduate Medical Education (ACGME) unveiled a new model to measure resident performance in 1999 that endorsed six general competencies. These include patient care, medical knowledge, practice-based learning, interpersonal and communication skills, professionalism, and system-based practice. The purpose behind the ACGME’s shift in measuring resident performance was to create an effective way to educate and evaluate physicians, explains Christian de Virgilio, MD. “The ultimate goal was to breed physicians who are well trained, educated, ethical, and compassionate.” Few studies have examined how successful surgical residency programs have been at achieving the ACGME-endorsed competencies. “The advent of the 80-hour workweek restriction and a 16-hour shift limit for interns has affected educational quality,” says Dr. de Virgilio. “Residents are now forced to compress required tasks into a shorter timeframe with reduced work hours. In turn, this can increase the likelihood that future surgical residents will be inadequately trained.” Examining Remediation Among Surgery Residents There are several measures of the adequacy of education for surgery residents. One of these measures is whether or not residents require any form of remediation during their residency. In the September 2012 Archives of Surgery, Dr. de Virgilio and colleagues had a study published that aimed to determine the frequency of resident remediation with regard to the six ACGME competencies. The study team also sought to identify factors predictive of the need for remediation and the rate of attrition by surgical residents. Dr. de Virgilio says “this information may provide insights into ways that we can more effectively modify the surgical curriculum in this new era of limited hours.” After conducting an 11-year retrospective...
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