title: Attainment of surgical competence in otolaryngology training.
abstract: OBJECTIVE
  Our aim was to determine the postgraduate year (PGY) of residency at which residents achieve competence in key otolaryngologic procedures as perceived by residents and program directors (PDs), determine resident or programmatic factors affecting PGY at which residents perceive attainment of competence, and evaluate the relationship between resident and PD perceptions for attainment of competence in these procedures.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  We surveyed residents and PDs in US otolaryngology residencies in 2011 using SurveyMonkey.com and assessed subjective attainment of competence by residents for 32 otolaryngologic procedures. PGY at which subjective competence achieved per resident perception was determined using a logistic regression model; PD perception was determined by mean calculation.
  
  
  RESULTS
  Two hundred seventy-seven residents (19.45%) and 39 PDs (37.86%) completed surveys. Residents achieved subjective competence later than expected by PDs for 25 of 32 procedures, although differences were generally small. The largest disparities were observed for nonsurgical office-based procedures, for which <90% of residents reported competence by PGY-5, whereas PDs expected competence before PGY-3. The greatest number of disparities was present in the subspecialty area of facial plastic and reconstructive surgery. Male gender predicted earlier self-reported attainment of competence in 10 of 32 procedures (P < .05). Degrees held, fellowship plans, and the size of the program were not significant predictors of PGY at which residents reported competence for most procedures.
  
  
  CONCLUSIONS
  We provide baseline data on PGY at which residents and PDs feel competence is achieved in key otolaryngologic procedures. These results may guide milestone development for resident training and assessment.
  
  
  METHODS
  NA.
authors.affiliation: Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Chadwick
authors.forename: Kelley M
authors.initials: KM
authors.lastname: Dodson
authors.forename: Wen
authors.initials: W
authors.lastname: Wan
authors.forename: Evan R
authors.initials: ER
authors.lastname: Reiter
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010036:Otolaryngology / Q000193:education*; D010038:Otorhinolaryngologic Diseases / Q000601:surgery*; D011795:Surveys and Questionnaires; D014481:United States
keywords: Pediatric general; allergy/rhinology; facial plastic/reconstructive; head and neck; otology; residency training; surgical competence