title: The impact of an acute care surgery team on general surgery residency.
abstract: BACKGROUND
  Acute care surgical teams (ACSTs) have limited data in residency. We sought to determine the impact of an ACST on the depth and breadth of general surgery resident training.
  
  
  METHODS
  One year prior to and after implementation of an ACST, Accreditation Council for Graduate Medical Education case logs spanning multiple postgraduate year levels were compared for numbers, case types, and complexity.
  
  
  RESULTS
  We identified 6,009 cases, including 2,783 after ACST implementation. ACSTs accounted for 752 cases (27%), with 39.2% performed laparoscopically. ACST cases included biliary (19.4%), skin/soft tissue (10%), hernia (9.8%), and appendix (6.5%). Second-year residents performed a lower percentage of laparoscopic cases after the creation of the ACST (20.4% vs 26.3%; P = .003), while chief residents performed a higher percentage (42.1 vs 37.4; P = .04). Case numbers and complexity following ACST development were unchanged within all year groups (P > .1).
  
  
  CONCLUSIONS
  ACST in a residency program does not sacrifice resident case complexity, diversity, or volume.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA. Electronic address: qhatch@gmail.com.
authors.forename: Quinton
authors.initials: Q
authors.lastname: Hatch
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA.
authors.forename: Derek
authors.initials: D
authors.lastname: McVay
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA.
authors.forename: Eric K
authors.initials: EK
authors.lastname: Johnson
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA, USA.
authors.forename: Justin A
authors.initials: JA
authors.lastname: Maykel
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, Case Western University, Cleveland, OH, USA.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Champagne
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Steele
mesh_terms: D000208:Acute Disease; D004503:Education, Medical, Graduate / Q000458:organization & administration* / Q000706:statistics & numerical data; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration* / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration* / Q000706:statistics & numerical data; D015397:Program Evaluation; D013514:Surgical Procedures, Operative / Q000193:education* / Q000706:statistics & numerical data; D014481:United States; D016526:Workload
keywords: Acute care surgery; Residency; Surgery; Training