Surgical rotations: the good, the bad, and the ugly.
BACKGROUND
Every surgeon's career begins with a surgical residency. Each residency has dreaded rotations as well as those that seem ideal, but to date, no objective criteria exist to define such rotations. The aim of this study is to establish objective criteria that, when applied to a specific rotation, will define it as a "dream" or a "dreaded" rotation and, in the process, elucidate the good, the bad, and the ugly of surgical rotations in general.


METHODS
All 39 residents from a multi-institutional residency program were asked to collaboratively identify the criteria they felt necessary for a dream rotation. Each resident evaluated 16 rotations at 4 hospitals using the identified criteria on a scale of "Inadequate," "Optimal," and "Ideal/Dream Rotation." Residents then gave an overall evaluation of each rotation as a dream rotation on a scale of "No," "For the Most Part," or "Yes." Finally, each resident was asked whether the individual rotations were following ACGME recommendations on duty hours.


RESULTS
The best correlations with a dream rotation were: clinical experience - quality and quantity of cases (r = 0.83), operative experience (r = 0.83), patient management responsibilities (r = 0.78), and outpatient office experience (r = 0.77). All p-values were < 0.05. The following correlated less with a dream rotation: conferences (r = 0.56, p < 0.05), medical student experience (r = 0.56, p < 0.05), and hospital facilities (r = 0.28, not significant.). Scut work was the only category for which there was a negative correlation with a dream rotation (r = -0.53, p < 0.05). Eighty-six percent of residents reported compliance with ACGME work hour recommendations, with no apparent correlation with a dream rotation.
Maker
Vijay K
VK
University of Illinois Metropolitan Group Hospitals Residency in General Surgery, Chicago, Illinois 60657, USA. vijay.maker-md@advocatehealth.com
Curtis
Kellie D
KD
Donnelly
Michael B
MB
D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D013502:General Surgery / Q000193:education*; D006748:Hospital Departments; D006801:Humans; D007396:Internship and Residency / Q000145:classification*; D007400:Interprofessional Relations; D005791:Patient Care; D015397:Program Evaluation; D013997:Time Factors; D014940:Work Schedule Tolerance; D016526:Workload