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Understanding Why Residents May Inaccurately Log Their Role in Operations: A Look at the 2013 In-Training Examination Survey

Wednesday, October 14, 2015

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Source Name: Annals of Thoracic Surgery


Michael P. Robich, MD, MSPH, Andrew Flagg, BA, Damien J. LaPar, MD, MS, David D. Odell, MD, MS, William Stein, MD, Muhammad Aftab, MD, Kathleen S. Berfield, MD, Amanda L. Eilers, DO, Shawn S. Groth, MD, MS, John F. Lazar, MD, Asad A. Shah, MD, Danielle A. Smith, MD, Elizabeth H. Stephens, MD, PhD, Cameron T. Stock, MD, Walter F. DeNino, MD, Vakhtang Tchantchaleishvili, MD, Edward G. Soltesz, MD, MPH

During the 2013 In-Training Exam for cardiothoracic surgery residents, 312 residents were surveyed regarding their training.  Residents self-reported that only 70-75% of the cases they claimed 'surgeon' credit met the ABTS definition for 'surgeon'--i.e., the resident performs "those technical manipulations that constituted the essential parts of the procedure itself" and has substantial involvement in preoperative and postoperative care.  What are the reasons that residents feel they need to 'over-report' their cases?  What are the implications of this study?


As we all know, cardiovascular surgery has changed during recent years in a way, that the simple cases are mostly treated by our interventional partners and that our patients get older and multimorbid. When I started my training, my first "coronaries" were single grafts. Today we don´t see these patients anymore and if one of our talented young residents should finally do his first case, it is also a single graft - propably even more difficult than in our early times - and we do the other grafts in this octogenerian patient with a triple vessel disease and over time the relation will become 2/2, 3/1 and finally 4/0, depending on talent and learning curve. That is propably the way to find a balance between the expectations of our patients and our residents in teaching hospitals today and it is our task to communicate this with our young colleagues.

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