For students who required remediation, nearly three in four were found to have significant deficiencies in medical knowledge rather than any of the other five competencies on which their competencies are judged.
In an invited critique in the same issue of the journal, Karen Deveney, MD, of the Department of Surgery at Oregon Health & Science University in Portland, asked:
"These surgical residents were a smart, high-achieving group of people. Why did so many stumble during residency and require remediation? The authors suggest deficient preparation during medial school for the rigors of surgical residency, inadequate education during residency, or the increased efficiency needed to compress required tasks into a shorter timeframe with decreased work hours.
"All of these are likely contributors." She added that these residents must care for patients who are sicker and more complex than in the past and fast-track them through the system.
"There is little time in the work day for contemplation or for learners who require a bit more time to master concepts or skills."
She called for the a renewed effort for educators to create systems that "eliminate nonessential tasks so that residents can devote more attention during the compressed work hours to learning what they need to become competent surgeons."