Optimizing the Selection of General Surgery Residents: A National Consensus

• Published in: Journal of surgical education Vol. 74; no. 1; pp. 100 - 107
• Main Authors: Louridas, Marisa, MD, Szasz, Peter, MD, Montbrun, Sandra de, MD, MEd, FRCSC, Harris, Kenneth A., MD, FRCSC, FACS, Grantcharov, Teodor P., MD, PhD, FACS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2017
• Subjects: Canada; Consensus; Delphi Technique; Education, Medical, Graduate - organization & administration; Female; general surgery; General Surgery - education; Guidelines as Topic - standards; Humans; Internship and Residency - standards; Male; Medical Knowledge; Medical Staff, Hospital - standards; Personnel Selection - standards; post graduate education; Practice-Based Learning and Improvement; selection; Surgery; surgical residency; technical skill; selection; Medical Knowledge; general surgery; surgical residency; Practice-Based Learning and Improvement; technical skill; post graduate education
• DOI: 10.1016/j.jsurg.2016.06.015
• ISSN: 1931-7204

Background Surgical programs strive to recruit trainees who will graduate as competent surgeons; however, selection processes vary between institutions. The purpose of the present study was to (1) solicit program directors’ (PDs) opinions on the proportion of trainees who have difficulty achieving competence and (2) establish consensus on the desired attributes of general surgery (GS) candidates and the technical skills that would be most indicative of future performance. Methods Delphi consensus methodology was used. An open-ended questionnaire, followed by a closed-ended questionnaire, formulated as a 5-point Likert scale, was administered. A Cronbach α ≥ 0.8 with 80% of responses in agreement (4—agree and 5—strongly agree) determined the threshold for consensus. Results The first and second rounds were completed by 14 and 11, of a potential 17, GS PDs, respectively. PDs felt that 5% or less of trainees have difficulty reaching competence in clinical knowledge, 5% to 10% in decision-making, and 5% to 15% in technical skill by the time of completion of training. Consensus was excellent ( α = 0.92). The top attributes for success in GS included work ethic and passion for surgery. Technical skills that felt to be most appropriate were open tasks (one-handed tie and subcuticular suture) and laparoscopic tasks (coordination, grasping, and cutting). Conclusion PDs indicate that of the 3 domains, the largest proportion of trainees had difficulty reaching competence in technical skill. Consensus among PDs suggests that top personal attributes include work ethic and passion for surgery. Consensus of technical tasks for inclusion into selection was basic open and laparoscopic skills.