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General surgery education has continued to evolve regarding test preparation, simulation, and skill acquisition. The "Resident as Educator" (RAE) model has been proposed and enacted by programs as a viable education model for general surgery education. This study examines the current education structures in general surgery residency programs in the United States and how many programs have adopted the RAE model or aspects of the model.A 20-question survey regarding education structure was distributed to all program directors in October 2021. Questions focused on the involvement of residents in leading education sessions, creating the weekly education schedule, program feedback to residents on teaching, and recognition for distinguished resident educators.A total of 156 programs responded to the survey. The response rate was 60%. 76.4% of the respondents have a combination of resident and faculty-led didactic sessions, 8.5% have an RAE model, and 15% have faculty-led education sessions. In terms of concerns regarding resident-led didactics-24.4% of respondents stated that their main concern would be the quality of education provided, and 20.4% referenced low resident satisfaction levels with resident-led education. There were no differences among the groups regarding the American Board of Surgery board passage rates.Most residency programs have adopted a model in which residents have significant involvement in creating and maintaining the education calendar and leading formal education sessions. However, only 8.5% have a purely resident-led educational curriculum among the responding programs. More studies are needed to assess how to implement a resident as educator model successfully.

This reflective essay explores my family’s intergenerational experiences of belonging and exclusion in and through Canadian spaces. I share how my parents, first generation Canadians, navigated cultural and religious traditions in order to help their children “pass” as Canadians–meaning, performing “norms” of perceived “Canadian-ness” to fit in. For me, the implications of this resulted in tensions around my identity and self-worth. I unpack personal stories of residing within a “third space,” as a second generation Canadian who identifies as and is also visibly identified as, South Asian and Muslim. I close the essay by appealing to Derrida’s concept of “unconditional hospitality” as a pedagogical parenting and teaching tool to inform my own children’s multifaceted identities as Canadians.

With the increasing age of patients, more patients on chronic preoperative steroids are undergoing liver resections. Our study aimed to assess the relationship between preoperative steroids and outcomes.We performed a retrospective review of the 2014-2019 NSQIP database of all patients undergoing liver resections. Propensity score matching was utilized to match the two groups (chronic steroids vs. no steroids) based on demographics, preoperative laboratory data, and operative findings. The primary outcome measure was mortality.There were 712 patients in the chronic steroid group and 21,751 in the no steroid group. After propensity score matching; there were 420 patients in both groups. Post-match analysis again demonstrated that patients on chronic steroids were at higher risk of cardiac arrest than those not on steroids (OR 2.01, 95% CI 1.02-2.45, p = 0.04). In addition, rates of organ space wound infection (OR 2.66, CI 1.33-5.38, p = 0.03), superficial wound infection (OR 2.79, CI 1.08-5.41, p = 0.035), renal insufficiency (OR 1.25, CI 1.03-1.62, p = 0.02), postoperative sepsis (OR 1.28, CI 1.08-1.82, p = 0.04), DVT (OR 1.7, CI 1.01-2.82, p = 0.04), and bile leakage (OR 1.75, CI 1.24-3.36, p = 0.04) were also increased in patients on steroids. However, the matched cohorts were similar in postoperative mortality rates (OR 0.11, CI 0.6-1.17, p = 0.72).The study found higher morbidity rates in patients undergoing liver resections on chronic preoperative steroids but no differences in mortality.

Recently, a new liver allocation policy called the acuity circles (AC) framework was implemented to decrease geographic disparities in transplant metrics across donor service areas. Early analyses have examined the changes in outcomes because of the AC policy. However, perceptions among transplant surgeons and staff regarding the new policy remain unknown.A 28-item survey was sent to division chiefs and surgical directors of liver transplantation across the United States. Questions assessed the respondents' perceptions regarding center-level metrics and staff satisfaction. We used Organ Procurement and Transplantation Network data to study differences in allocation between the pre-AC implementation period (2019) and the post-AC implementation period (2020-2021).A total of 40 participants completed this ongoing survey study. Most responses were from region 8 (13%), region 10 (15%), and region 11 (13%). Sixty-three percent of respondents stated that the wait time for a suitable offer for recipients with model of end-stage liver disease score30 has decreased, whereas 50% stated that wait time for a suitable offer for recipients with model of end-stage liver disease score30 has increased. However, most respondents (75%) felt that the average cost per transplant had increased and that the rate of surgical complications and 1-y graft survival had remained the same. In most states, an observable decrease in in-state liver transplantations occurred each year between 2019 and 2021. In addition, most allocation regions reported an increase in donations after circulatory deaths between 2019 and 2021.Perceptions of the new AC policy among liver transplant surgeons in the United States remain mixed, highlighting the potential strengths and concerns regarding its future impact. Further studies should assess the effects of the AC policy on clinical outcomes and liver transplantation access.

Radiological assessment is an important skill to develop in general surgery training. Therefore, we aimed to determine general surgery residents' points of view on receiving formal radiology didactics.We performed an anonymous survey of general surgery residents throughout the USA. The survey queried the residents' postgraduate year, training program type, diagnostic radiology education in their training program, as well as the residents' comfort level in interpreting various imaging modalities, followed by a series of images to assess the residents' ability to interpret images showing various surgical disease processes.A total of 365 residents responded to the survey. In total, 76.6% of the respondent states that there is no structured didactic session in their program on radiological studies. However, 66.3% felt that interpretation of radiological images should be used to determine surgical competency and promotion to the next academic year. In terms of accurately reading images-68.7% of the residents were able to read an X-ray showing cecal volvulus correctly, 51.9% were able to read a cholangiogram correctly, and 95.3% were correctly read an X-ray showing free under the diaphragm.Most residents favored having radiological assessments as part of the competency evaluation. Furthermore, a curriculum and inbuilt training structure that aims to ensure residents develop competent clinical image interpretation abilities may enhance the development and retention of such skills, ultimately influencing patient outcomes.

The population of 2nd generation Canadian-Muslim women who choose to veil, or wear the hijab, is steadily increasing. Rather than inquire why these women choose to do so, this study explores how Muslim youth use the veil as a fashion accessory. Guided by research questions that focus on the representation of the veil in popular culture, this study explores the veil as a sign as the women negotiate ‘being Muslim’ and ‘being Canadian’. Informed by a cultural studies conceptual framework, veiling in fashionable ways, or, ‘voguing the veil’, is explored as a form of ‘public pedagogy’ (Giroux, 2004). Using an Advocacy and Participatory methodology, the four women and myself engage in a collaborative inquiry examining meanings behind how we vogue the veil. Through a series of interviews, focus groups and journal entries accompanied by personal photographs (photovoice), the women and I co-construct narratives around their identity as women who veil in ways that contest dominant discourse. Together we explore the impact of constructs such as beauty, femininity and sexuality on our identities as Muslim women who veil in Canada. Co-constructing participant case studies permits readers “access to the world from the view-point of individuals who have not traditionally held control over the means of imaging the world” (Berg, 2007, p. 233), at many times surprising and contradicting what is ‘known’ about the veiled Muslim woman. The findings reveal themes that deeply impact how the women choose to veil. These themes include the strategies the women use to employ their veils as a means of agency and how, within and through different pedagogical spaces, the women’s performances and performativity of the veil shifts. The women in the study demonstrate that by ‘voguing the veil’, they are in fact attempting to transform the meaning of the veil as a marker of Canadian Identity. Using the voices, photos and narratives of the four women I argue that through ‘voguing the veil’ these young Muslim women are actively entering into and creating spaces so to be seen as an integral part of Canadian society and as such can be recognized as an emerging subculture.