title: General surgery training without laparoscopic surgery fellows: the impact on residents and patients.
abstract: BACKGROUND
  To evaluate resident case volume after discontinuation of a laparoscopic surgery fellowship, and to examine disparities in patient care over the same time period.
  
  
  METHODS
  Resident case logs were compared for a 2-year period before and 1 year after discontinuing the fellowship, using a 2-sample t test. Databases for bariatric and esophageal surgery were reviewed to compare operative time, length of stay (LOS), and complication rate by resident or fellow over the same time period using a 2-sample t test.
  
  
  RESULTS
  Increases were seen in senior resident advanced laparoscopic (Mean Fellow Year = 21 operations vs Non Fellow Year = 61, P < 0.01), esophageal (1 vs 11, P < .01) and bariatric volume (9 vs 36, P < .01). Junior resident laparoscopic volume increased (P < 0.05). No difference in LOS or complication rate was seen with resident vs fellow assistant. Operative time was greater for gastric bypass with resident assistant (152 ± 51 minutes vs 138 ± 53, P < .05).
  
  
  CONCLUSIONS
  Discontinuing a laparoscopic fellowship significantly increases resident case volume in laparoscopic surgery. Operative time for complex operations may increase in the absence of a fellow. Other patient outcomes are not affected by this change.
authors: Department of Surgery, Northwestern University, Chicago, IL 60611, USA.
authors: John G
authors: JG
authors: Linn
authors: Eric S
authors: ES
authors: Hungness
authors: Sara
authors: S
authors: Clark
authors: Alexander P
authors: AP
authors: Nagle
authors: Edward
authors: E
authors: Wang
authors: Nathaniel J
authors: NJ
authors: Soper
mesh_terms: D000046:Academic Medical Centers; D050110:Bariatric Surgery / Q000193:education / Q000706:statistics & numerical data; D002641:Chicago; D016208:Databases, Factual; D013505:Digestive System Surgical Procedures / Q000193:education / Q000706:statistics & numerical data; D005257:Fellowships and Scholarships; D013502:General Surgery / Q000193:education* / Q000706:statistics & numerical data; D054625:Healthcare Disparities; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education* / Q000706:statistics & numerical data; D016526:Workload / Q000706:statistics & numerical data