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The Resident Experience on Trauma: Declining Surgical Opportunities and Career Incentives? Analysis of Data from a Large Multi-institutional Study
- Source :
- The Journal of Trauma: Injury, Infection, and Critical Care. 54:1-8
- Publication Year :
- 2003
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2003.
-
Abstract
- Purpose: The surgical resident experience with trauma has changed. Many residents are exposed to predominantly nonoperative patient care experiences while on trauma rotations. Data from a large multicenter study were analyzed to estimate surgical resident exposure to trauma laparotomy, diagnostic peritoneal lavage (DPL), and focused abdominal sonography for trauma (U/S). Methods: Centers completed a self-report questionnaire on their institutional demographics, admissions, and procedure for a 2-year period (1998-1999). Results: A total of 82 trauma centers that provide resident teaching were included. The included centers represent over 247,000 trauma admissions. The majority of trauma centers (65.9%) had > 80% blunt injury. Although all centers performed laparotomies, other results were more variable. For U/S, 24.2% performed none at all and 47.0% performed fewer than two U/S examinations per month. For DPLs, 3.8% performed none and 66.7% performed fewer than two per month. Assuming 1 night of 4 on call, the average surgical resident training at a trauma center performing > 80% blunt trauma has the potential to participate in only 15 trauma laparotomies, 6 diagnostic peritoneal lavages, and 45 ultrasound examinations per year. In addition, the resident will care for an average of 500 blunt trauma patients before performing a splenectomy or liver repair. Conclusion: Surgical resident experience on most trauma services is heavily weighted to nonoperative management, with a relatively low number of procedures, little experience with DPL, and highly variable experience with ultrasound. These data have serious implications for resident training and recruitment into the specialty.
- Subjects :
- medicine.medical_specialty
Attitude of Health Personnel
medicine.medical_treatment
Specialty
Traumatology
Critical Care and Intensive Care Medicine
Patient Admission
Diagnostic peritoneal lavage
Blunt
Trauma Centers
Surveys and Questionnaires
Laparotomy
medicine
Humans
Focused assessment with sonography for trauma
Peritoneal Lavage
Ultrasonography
Motivation
Career Choice
medicine.diagnostic_test
business.industry
General surgery
Trauma center
Internship and Residency
United States
Education, Medical, Graduate
Blunt trauma
Case-Control Studies
Workforce
Physical therapy
Wounds and Injuries
Surgery
Clinical Competence
business
Subjects
Details
- ISSN :
- 00225282
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- The Journal of Trauma: Injury, Infection, and Critical Care
- Accession number :
- edsair.doi.dedup.....2756e2e057b258b4603a6746debfcee5