"Resident remediation places additional strain on the program director and entire clinical faculty," they wrote. It may complicate patient care, load more work on other providers, increase the need for communication and faculty supervision.
De Virgilio says an open question is whether the 80-hour work-week limitation for such medical school trainees is to blame. The researchers did not compare periods before that limit took effect in 2003. But de Virgilio says it raises an important question about whether the end result may be that "our surgeons in the future come out of these programs with the same amount of training as in the past."
But he and his fellow authors wrote that the 31% remediation rate for these residents is "surprising given that the resident cohort was a relatively high-achieving group," which picks the top students from high school and undergraduate institutions.
Additionally, de Virgilio says, "California has one of the more competitive areas for surgery in the country and surgery is one of the more competitive fields in medicine, so we have the fortune to be educating the top students of the future. I would say that the vast majority of them are very trainable, they have the intelligence and skill. It's just a matter of carefully trying to tweak them to get to that point."