title: Surgical Training and the Early Specialization Program: Analysis of a National Program.
abstract: BACKGROUND
  The Early Specialization Program (ESP) in surgery was designed by the American Board of Surgery, the American Board of Thoracic Surgery, and the Residency Review Committees for Surgery and Thoracic Surgery to allow surgical trainees dual certification in general surgery (GS) and either vascular surgery (VS) or cardiothoracic surgery (CTS) after 6 to 7 years of training. After more than 10 years' experience, this analysis was undertaken to evaluate efficacy.
  
  
  METHODS
  American Board of Surgery and American Board of Thoracic Surgery records of VS and CTS ESP trainees were queried to evaluate qualifying exam and certifying exam performance. Case logs were examined and compared with contemporaneous non-ESP trainees. Opinions of programs directors of GS, VS, and CTS and ESP participants were solicited via survey.
  
  
  RESULTS
  Twenty-six CTS ESP residents have completed training at 10 programs and 16 VS ESP at 6 programs. First-time pass rates on American Board of Surgery qualifying and certifying exams were superior to time-matched peers; greater success in specialty specific examinations was also found. Trainees met required case minimums for GS despite shortened time in GS. By survey, 85% of programs directors endorsed satisfaction with ESP, and 90% endorsed graduate readiness for independent practice. Early Specialization Program participants report increased mentorship and independence, greater competence for practice, and overall satisfaction with ESP.
  
  
  CONCLUSIONS
  Individuals in ESP programs in VS and CTS were successful in passing GS and specialty exams and achieving required operative cases, despite an accelerated training track. Programs directors and participants report satisfaction with the training and confidence that ESP graduates are prepared for independent practice. This documented success supports ESP training in any surgical subspecialty, including comprehensive GS.
authors.affiliation: Department of Surgery, Washington University in St Louis, St Louis, MO. Electronic address: klingensmithm@wustl.edu.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Klingensmith
authors.affiliation: Accreditation Council for Graduate Medical Education, Chicago, IL.
authors.forename: John R
authors.initials: JR
authors.lastname: Potts
authors.affiliation: Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Walter H
authors.initials: WH
authors.lastname: Merrill
authors.affiliation: Department of Surgery, Washington University in St Louis, St Louis, MO.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Eberlein
authors.affiliation: American Board of Surgery, Philadelphia, PA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Rhodes
authors.affiliation: Department of Surgery, Brigham and Women's Hospital, Boston, MA.
authors.forename: Stanley W
authors.initials: SW
authors.lastname: Ashley
authors.affiliation: Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: R James
authors.initials: RJ
authors.lastname: Valentine
authors.affiliation: Department of Surgery, Oregon Health and Sciences University, Portland, OR.
authors.forename: John G
authors.initials: JG
authors.lastname: Hunter
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Stain
mesh_terms: D001291:Attitude of Health Personnel; D002568:Certification; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D015397:Program Evaluation; D013038:Specialization; D013043:Specialties, Surgical / Q000193:education*; D014481:United States