title: General surgery resident rotations in surgical critical care, trauma, and burns: what is optimal for residency training?
abstract: BACKGROUND
  There are no specific Accreditation Council for Graduate Medical Education General Surgery Residency Program Requirements for rotations in surgical critical care (SCC), trauma, and burn. We sought to determine the experience of general surgery residents in SCC, trauma, and burn rotations.
  
  
  METHODS
  Data analysis of surgical rotations of American Board of Surgery general surgery resident applicants (n = 7,299) for the last 8 years (2006 to 2013, inclusive) was performed through electronic applications to the American Board of Surgery Qualifying Examination. Duration (months) spent in SCC, trauma, and burn rotations, and postgraduate year (PGY) level were examined.
  
  
  RESULTS
  The total months in SCC, trauma and burn rotations was mean 10.2 and median 10.0 (SD 3.9 months), representing approximately 16.7% (10 of 60 months) of a general surgery resident's training. However, there was great variability (range 0 to 29 months). SCC rotation duration was mean 3.1 and median 3.0 months (SD 2, min to max: 0 to 15), trauma rotation duration was mean 6.3 and median 6.0 months (SD 3.5, min to max: 0 to 24), and burn rotation duration was mean 0.8 and median 1.0 months (SD 1.0, min to max: 0 to 6). Of the total mean 10.2 months duration, the longest exposure was 2 months as PGY-1, 3.4 months as PGY-2, 1.9 months as PGY-3, 2.2 months as PGY-4 and 1.1 months as PGY-5. PGY-5 residents spent a mean of 1 month in SCC, trauma, and burn rotations. PGY-4/5 residents spent the majority of this total time in trauma rotations, whereas junior residents (PGY-1 to 3) in SCC and trauma rotations.
  
  
  CONCLUSIONS
  There is significant variability in total duration of SCC, trauma, and burn rotations and PGY level in US general surgery residency programs, which may result in significant variability in the fund of knowledge and clinical experience of the trainee completing general surgery residency training. As acute care surgery programs have begun to integrate emergency general surgery with SCC, trauma, and burn rotations, it is an ideal time to determine the optimal curriculum and duration of these important rotations for general surgery residency training.
authors.affiliation: University of Michigan, Ann Arbor, MI, USA. Electronic address: lenan@umich.edu.
authors.forename: Lena M
authors.initials: LM
authors.lastname: Napolitano
authors.affiliation: American Board of Surgery, Philadelphia, PA, USA.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Biester
authors.affiliation: UC Davis Health System, Sacramento, CA, USA.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Jurkovich
authors.affiliation: American Board of Surgery, Philadelphia, PA, USA.
authors.forename: Jo
authors.initials: J
authors.lastname: Buyske
authors.affiliation: American Board of Surgery, Philadelphia, PA, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Malangoni
authors.affiliation: American Board of Surgery, Philadelphia, PA, USA.
authors.forename: Frank R
authors.initials: FR
authors.lastname: Lewis
mesh_terms: D002056:Burns; D003422:Critical Care; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D013997:Time Factors; D014193:Trauma Centers; D014194:Traumatology / Q000193:education*; D014481:United States
keywords: Burn; Duration; General surgery; General surgery residency training; Rotation; Surgical critical care; Trauma