title: Training general surgery residents in pediatric surgery: educational value vs time and cost.
abstract: BACKGROUND
  This study evaluated the educational value of pediatric surgery rotations, the likelihood of performing pediatric operations upon completing general surgery (GS) residency, and time and cost of training GS residents in pediatric surgery.
  
  
  METHODS
  A survey was administered to GS residents that evaluated the pediatric surgery rotation and anticipated practice intentions. A retrospective analysis (2005-2006) of operative times for unilateral inguinal hernia repair, bilateral inguinal hernia repair, and umbilical hernia repair was also performed. Procedure times were compared for operations performed by a pediatric surgeon with and without GS residents. Cost analysis was based on time differences.
  
  
  RESULTS
  General surgery residents (n = 19) considered the pediatric surgery rotation to have high educational value (4.7 +/- 0.6 of 5) with extensive teaching (4.6 +/- 0.7) and operative experience (4.4 +/- 0.8). Residents listed pediatric surgery exposure, operative technique, and observed work ethic as most valuable. Upon graduation, residents expect to perform pediatric operations 2 to 3 times annually. Thirty-seven percent of residents felt competent to perform appendectomy (patients >5 years), 32% appendectomy (3-5 years), 21% gastrostomy (>1 year), and 11% inguinal herniorrhaphy (>1 year). Operative times and costs were significantly higher in operative procedures performed with a GS resident.
  
  
  CONCLUSIONS
  General surgery residents considered pediatric surgery as a valuable educational experience. Residents anticipate performing pediatric operations a few times annually. Training GS residents in pediatric surgery increased operative time and cost. This information may be useful in determining the appropriate setting for resident education as well as budget planning for pediatric surgical practices.
authors.affiliation: Kaiser Permanente, Los Angeles Medical Center, CA 90027, USA. slleemd@yahoo.com
authors.forename: Steven L
authors.initials: SL
authors.lastname: Lee
authors.forename: Roman M
authors.initials: RM
authors.lastname: Sydorak
authors.forename: Harry
authors.initials: H
authors.lastname: Applebaum
mesh_terms: D001291:Attitude of Health Personnel; D004503:Education, Medical, Graduate / Q000191:economics / Q000379:methods*; D013502:General Surgery / Q000191:economics / Q000193:education*; D059685:Herniorrhaphy; D006801:Humans; D007396:Internship and Residency / Q000191:economics; D010372:Pediatrics / Q000191:economics / Q000193:education*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors