title: Does surgery residency prepare residents to work at critical access hospitals?
abstract: BACKGROUND
  Operations performed by surgeons working at Critical Access Hospitals (CAHs) and surgery residents have not been compared.
  
  
  METHODS
  Procedure codes logged by general surgery residents graduating from our institution in 2013 and 2014 were obtained. Procedure codes were obtained for all CAHs in our state for 2012 to 2013. Clinically relevant categories were compared among residents and general surgeons at CAHs.
  
  
  RESULTS
  A total of 34,246 procedures logged by general surgeons at CAHs were compared with 31,977 procedures logged by surgery residents. Endoscopy comprised 56.1% of cases done by general surgeons versus 9.1% of cases by residents (P < .001). Excluding endoscopy, rural surgeons had higher percentages in hernia, skin/soft tissue, cholecystectomy/common bile duct, rectal/anal, and breast cases. Residents who completed a rural surgery rotation had higher numbers in small/large bowel, hernia, breast, and endoscopy.
  
  
  CONCLUSIONS
  Surgery residency provides less exposure to endoscopy compared with a general surgery practice at CAHs. A rural rotation increases endoscopic exposure.
authors: Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, USA. Electronic address: undurrag@ohsu.edu.
authors: Vicente
authors: V
authors: Undurraga Perl
authors: Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, USA.
authors: Brian
authors: B
authors: Diggs
authors: Division of Trauma, Critical Care & Acute Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, USA.
authors: Bruce
authors: B
authors: Ham
authors: Division of Trauma, Critical Care & Acute Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, USA.
authors: Martin
authors: M
authors: Schreiber
mesh_terms: D002983:Clinical Competence; D003422:Critical Care; D004503:Education, Medical, Graduate; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D019035:Rural Health Services; D014481:United States; D000078329:Workforce
keywords: Critical access hospitals; General surgery training; Procedures; Rural surgery