title: Perceptions of graduating general surgery chief residents: are they confident in their training?
abstract: BACKGROUND
  Debate exists within the surgical education community about whether 5 years is sufficient time to train a general surgeon, whether graduating chief residents are confident in their skills, why residents choose to do fellowships, and the scope of general surgery practice today.
  
  
  METHODS
  In May 2013, a 16-question online survey was sent to every general surgery program director in the United States for dissemination to each graduating chief resident (CR).
  
  
  RESULTS
  Of the 297 surveys returned, 76% of CRs trained at university programs, 81% trained at 5-year programs, and 28% were going directly into general surgery practice. The 77% of CRs who had done >950 cases were significantly more comfortable than those who had done less (p < 0.0001). Only a few CRs were uncomfortable performing a laparoscopic colectomy (7%) or a colonoscopy (6%), and 80% were comfortable being on call at a Level I trauma center. Compared with other procedures, CRs were most uncomfortable with open common bile duct explorations (27%), pancreaticoduodenectomies (38%), hepatic lobectomies (48%), and esophagectomies (60%) (p < 0.00001). Of those going into fellowships, 67% said they truly had an interest in that specialty and only 7% said it was because they were not confident in their surgical skills.
  
  
  CONCLUSIONS
  Current graduates of general surgery residencies appear to be confident in their skills, including care of the trauma patient. Fellowships are being chosen primarily because of an interest in the subspecialty. General surgery residency no longer provides adequate training in esophageal or hepatopancreatobiliary surgery.
authors: Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, MO. Electronic address: mark.friedell@tmcmed.org.
authors: Mark L
authors: ML
authors: Friedell
authors: Guthrie Clinic, Sayre, PA.
authors: Thomas J
authors: TJ
authors: VanderMeer
authors: Department of Surgery, Orlando Regional Medical Center, Orlando, FL.
authors: Michael L
authors: ML
authors: Cheatham
authors: Department of Surgery, Ochsner Clinic, New Orleans, LA.
authors: George M
authors: GM
authors: Fuhrman
authors: Department of Surgery, University of Nebraska School of Medicine, Omaha, NE.
authors: Paul J
authors: PJ
authors: Schenarts
authors: Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL.
authors: John D
authors: JD
authors: Mellinger
authors: Department of Surgery, University of Pennsylvania, Philadelphia, PA.
authors: Jon B
authors: JB
authors: Morris
mesh_terms: D001291:Attitude of Health Personnel; D002321:Career Choice; D002983:Clinical Competence; D003625:Data Collection; D004503:Education, Medical, Graduate; D005257:Fellowships and Scholarships; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D016015:Logistic Models; D008297:Male; D010820:Physicians / Q000523:psychology*; D020377:Self Efficacy; D013043:Specialties, Surgical / Q000193:education; D014481:United States