3 in 10 Surgery Residents Need Remediation

Cheryl Clark, for HealthLeaders Media , September 18, 2012

De Virgilio, the director of the general surgery residency program at Harbor-UCLA, notes that an anomaly in the researchers' findings is that students who received an "honor" recognition during their six to 12-week surgical clerkship were more likely to need remediation than students who did not receive that honor.

"That's counterintuitive," de Virgilio says, and may point to the need to re-evaluate the measures used to determine who such recognition. Also predictive of a student having to adhere to a remediation regimen was a relatively low score in the US Medical Licensing Examination, Step 1.

The fact that 31% of surgical residents needed additional help, however, puts a burden on these academic medical institutions.

The report looked at surgical resident training between 1999 and 2010 at Harbor-UCLA, the University of California Davis Medical Center, Loma Linda University, Stanford University, Cedars Sinai Medical Center, and the University of California Irvine Medical Center

The researchers wrote that the rate of remediation is of concern because it is several percentage points higher than similar studies of this type.

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2 comments on "3 in 10 Surgery Residents Need Remediation"

Napoleon Knight (9/20/2012 at 3:36 PM)
I agree with some of the comments, but I think the core issue is that we have cut back the number of hours that residents can care for patients, and not lenghthed the residency programs that they are in. If you simply do teh math, you can see that there likely is not enough time to develop the skills that are needed at the time that they finish their programs. I would suspect if you talked to others across the country, that you would likely hear that in residency programs with a large technical aspect, and even in those that are cognitive in nature, that the new physicians coming out do not seem to be at the same level as in the past. Further restriction of duty hours does not seem to be the issue to me. Ensuring adequate oversight of residents, and having a culture in which help and assistance can be summoned when needed worked well for me as a resident years ago, and I suspect could once again. As the old adage goes, you get what you pay for, and if we are paying for less experiences for those in training, then we should not be surprised out some of the outcomes. Not a great solution for the amazing needs of this great country going forward.

Larry R. Kaiser (9/18/2012 at 11:03 AM)
Harbor-UCLA is not the same as the UCLA School of Medicine that you refer to in your article. The surgery program that De Virgilio heads is separate and distinct from the program at the UCLA Medical Center in Westwood and you fail to make that distinction in your article. I would venture to say that attrition and remediation at the UCLA program (Program Director: O. Joe Hines)likely is not at the level of the other programs (though I don't have the actual data) that form the basis of the article reviewed. That being said the data presented certainly give one cause for concern not just from the actual educational experience provided during the residency but also as to the way that residents are selected. In addition you repeatedly refer to residents as "students' which is confusing. These "students" are graduates of approved medical schools and thus are physicians, albeit in residency programs.




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