title: Are general surgery residents ready to practice? A survey of the American College of Surgeons Board of Governors and Young Fellows Association.
abstract: BACKGROUND
  General surgery residency training has changed with adoption of the 80-hour work week, patient expectations, and the malpractice environment, resulting in decreased resident autonomy during the chief resident year. There is considerable concern that graduating residents are not prepared for independent surgical practice.
  
  
  METHODS
  Two online surveys were developed, one for "young surgeons" (American College of Surgeons [ACS] Fellows 45 years of age and younger) and one for "older surgeons" (ACS Fellows older than 45 years of age). The surveys were distributed by email to 2,939 young and 9,800 older surgeons. The last question was open-ended with a request to provide comments. A qualitative and quantitative analysis of all comments was performed.
  
  
  RESULTS
  The response rate was 9.6% (282 of 2,939) of young and 10% (978 of 9,800) of older surgeons. The majority of young surgeons (94% [58.7% strongly agree, 34.9% agree]) stated they had adequate surgical training and were prepared for transition to the surgery attending role (91% [49.6% strongly agree, 41.1% agree]). In contrast, considerably fewer older surgeons believed that there was adequate surgical training (59% [18.7% strongly agree, 40.2% agree]) or adequate preparation for transition to the surgery attending role (53% [16.93% strongly agree, 36.13% agree]). The 2 groups' responses were significantly different, chi-square test of association (3) = 15.73, p = 0.0012. Older surgeons focused considerably more on residency issues (60% vs 42%, respectively), and young surgeons focused considerably more on business and practice issues (30% vs 14%, respectively).
  
  
  CONCLUSIONS
  Young and older surgeons' perceptions of general surgery residents' readiness to practice independently after completion of general surgery residency differ significantly. Future work should focus on determination of specific efforts to improve the transition to independent surgery practice for the general surgery resident.
authors.affiliation: Department of Surgery, University of Michigan Health System, Ann Arbor, MI. Electronic address: lenan@umich.edu.
authors.forename: Lena M
authors.initials: LM
authors.lastname: Napolitano
authors.affiliation: University of Utah, South Jordan, UT.
authors.forename: Mark
authors.initials: M
authors.lastname: Savarise
authors.affiliation: Mount Sinai Medical Center, Miami Beach, FL.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Paramo
authors.affiliation: The Oregon Clinic, Portland, OR.
authors.forename: Laurel C
authors.initials: LC
authors.lastname: Soot
authors.affiliation: New York University, New York, NY.
authors.forename: S Rob
authors.initials: SR
authors.lastname: Todd
authors.affiliation: Muskogee Regional Medical Center, Muskogee, OK.
authors.forename: Jay
authors.initials: J
authors.lastname: Gregory
authors.affiliation: Sanford School of Medicine, University of South Dakota, Sioux Falls, SD.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Timmerman
authors.affiliation: Brown University School of Medicine, Providence, RI.
authors.forename: William G
authors.initials: WG
authors.lastname: Cioffi
authors.affiliation: American College of Surgeons, Chicago, IL.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Davis
authors.affiliation: American College of Surgeons, Chicago, IL.
authors.forename: Ajit K
authors.initials: AK
authors.lastname: Sachdeva
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003625:Data Collection; D004502:Education, Medical, Continuing / Q000592:standards*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000592:standards*; D012955:Societies, Medical; D013043:Specialties, Surgical / Q000193:education*; D014481:United States