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Smith SM, Chugh PV, Song C, Kim K, Whang E, Kristo G. Perspectives of Surgical Research Residents on Improving Their Reentry Into Clinical Training. JOURNAL OF SURGICAL EDUCATION 2024; 81:1491-1497. [PMID: 39217679 DOI: 10.1016/j.jsurg.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/01/2024] [Accepted: 07/12/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE Concerns exist about clinical and operative skill decay in surgery residents when they dedicate time away from clinical training to pursue research. However, it remains undetermined how to best prevent these negative impacts. Our study evaluated the perspectives of surgical research residents on interventions to improve their reentry into clinical training. DESIGN, SETTING, AND PARTICIPANTS An anonymous web-based survey was distributed between 5/01/2023 and 6/01/2023 to 102 current and former (within the previous 3 years) general surgery research residents from 4 academic medical centers in Boston, MA. RESULTS Survey response rate was 35.3% (36/102 residents). About 22 of 36 residents (61.1%) felt that their clinical aptitude decreased during the research years, whereas 33 of 36 (91.7%) reported reduced surgical skills. When reflecting on their re-entry to residency, former research residents reported feeling anxious and less confident (3.84/5 on a 1-5 Likert scale) as well as being below the expected level of clinical performance (3.42/5). Most of them (12 of 17; 70.6%) reported that it took up to 6 months, whereas 5 of them (29.4%) up to 12 months to feel at the expected level. When compared to nonmoonlighting residents, those who moonlighted often and operated during moonlighting, denied a decrease in clinical and surgical skills, and reported less anxiety, higher confidence, and a quicker return to the expected level of performance. Interventions proposed for improving their clinical re-entry included individualized development plans for 3 months before returning to clinical training, established curriculum for clinical work throughout the research years, clinical preceptorships throughout the research years, and simulation curriculum throughout the research years. CONCLUSIONS General surgery residents feel that their clinical and surgical skills decreased during the research years, leading to anxiety and lack of confidence when returning to residency. Therefore, comprehensive interventions are needed to improve the reentry of the research residents into clinical training.
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Affiliation(s)
- Sophia M Smith
- Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA; Department of Surgery, Boston Medical Center, Boston University, Boston, MA
| | - Priyanka V Chugh
- Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA; Department of Surgery, Boston Medical Center, Boston University, Boston, MA
| | - Carolyn Song
- Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA; Department of Surgery, Boston Medical Center, Boston University, Boston, MA
| | - Kiryung Kim
- Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Edward Whang
- Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Gentian Kristo
- Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA; Department of Surgery, Boston Medical Center, Boston University, Boston, MA; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
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LaPolla FWZ, Barber Grossi M, Chen S, Guo TW, Havranek K, Jebb O, Nguyen MT, Panganamamula S, Smith N, Sundaresh S, Yu J, Mayer G. All of whom? Limitations encountered using All of Us Researcher Workbench in a Primary Care residents secondary data analysis research training block. J Am Med Inform Assoc 2024:ocae162. [PMID: 38917426 DOI: 10.1093/jamia/ocae162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/17/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVES The goal of this case report is to detail experiences and challenges experienced in the training of Primary Care residents in secondary analysis using All of Us Researcher Workbench. At our large, urban safety net hospital, Primary Care/Internal Medicine residents in their third year undergo a research intensive block, the Research Practicum, where they work as a team to conduct secondary data analysis on a dataset with faculty facilitation. In 2023, this research block focused on use of the All of Us Researcher Workbench for secondary data analysis. MATERIALS AND METHODS Two groups of 5 residents underwent training to access the All of Us Researcher Workbench, and each group explored available data with a faculty facilitator and generated original research questions. Two blocks of residents successfully completed their research blocks and created original presentations on "social isolation and A1C" levels and "medical discrimination and diabetes management." RESULTS Departmental faculty were satisfied with the depth of learning and data exploration. In focus groups, some residents noted that for those without interest in performing research, the activity felt extraneous to their career goals, while others were glad for the opportunity to publish. In both blocks, residents highlighted dissatisfaction with the degree to which the All of Us Researcher Workbench was representative of patients they encounter in a large safety net hospital. DISCUSSION Using the All of Us Researcher Workbench provided residents with an opportunity to explore novel questions in a massive data source. Many residents however noted that because the population described in the All of Us Researcher Workbench appeared to be more highly educated and less racially diverse than patients they encounter in their practice, research may be hard to generalize in a community health context. Additionally, given that the data required knowledge of 1 of 2 code-based data analysis languages (R or Python) and work within an idiosyncratic coding environment, residents were heavily reliant on a faculty facilitator to assist with analysis. CONCLUSION Using the All of Us Researcher Workbench for research training allowed residents to explore novel questions and gain first-hand exposure to opportunities and challenges in secondary data analysis.
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Affiliation(s)
| | - Marco Barber Grossi
- Department of General Internal Medicine and Clinical Innovations, NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
| | - Sharon Chen
- Department of General Internal Medicine and Clinical Innovations, NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
| | - Tai Wei Guo
- Department of General Internal Medicine and Clinical Innovations, NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
| | - Kathryn Havranek
- Department of General Internal Medicine and Clinical Innovations, NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
| | - Olivia Jebb
- Department of General Internal Medicine and Clinical Innovations, NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
| | - Minh Thu Nguyen
- Department of General Internal Medicine and Clinical Innovations, NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
| | - Sneha Panganamamula
- NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
| | - Noah Smith
- Department of General Internal Medicine and Clinical Innovations, NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
| | - Shree Sundaresh
- Department of General Internal Medicine and Clinical Innovations, NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
| | - Jonathan Yu
- Department of General Internal Medicine and Clinical Innovations, NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
| | - Gabrielle Mayer
- Department of General Internal Medicine and Clinical Innovations, NYU Langone Health Grossman School of Medicine, New York, NY 10016, United States
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LaPolla FWZ, Milliken G, Gillespie C. Attitudes on data reuse among internal medicine residents. J Med Libr Assoc 2024; 112:81-87. [PMID: 39119170 PMCID: PMC11305464 DOI: 10.5195/jmla.2024.1772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024] Open
Abstract
Background NYU Langone Health offers a collaborative research block for PGY3 Primary Care residents that employs a secondary data analysis methodology. As discussions of data reuse and secondary data analysis have grown in the data library literature, we sought to understand what attitudes internal medicine residents at a large urban academic medical center had around secondary data analysis. This case report describes a novel survey on resident attitudes around data sharing. Methods We surveyed internal medicine residents in three tracks: Primary Care (PC), Categorical, and Clinician-Investigator (CI) tracks as part of a larger pilot study on implementation of a research block. All three tracks are in our institution's internal medicine program. In discussions with residency directors and the chief resident, the term "secondary data analysis" was chosen over "data reuse" due to this being more familiar to clinicians, but examples were given to define the concept. Results We surveyed a population of 162 residents, and 67 residents responded, representing a 41.36% response rate. Strong majorities of residents exhibited positive views of secondary data analysis. Moreover, in our sample, those with exposure to secondary data analysis research opined that secondary data analysis takes less time and is less difficult to conduct compared to the other residents without curricular exposure to secondary analysis. Discussion The survey reflects that residents believe secondary data analysis is worthwhile and this highlights opportunities for data librarians. As current residents matriculate into professional roles as clinicians, educators, and researchers, libraries have an opportunity to bolster support for data curation and education.
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Affiliation(s)
- Fred Willie Zametkin LaPolla
- , Research and Data Librarian, Head of Data Services, NYU Health Sciences Library, NYU Langone Health, New York City, NY
| | - Genevieve Milliken
- , Data Services Librarian, NYU Health Sciences Library, NYU Langone Health, New York City, NY
| | - Colleen Gillespie
- , Institute for Innovations in Medical Education, New York University Grossman School of Medicine, NYU Langone Health, New York City, NY
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Romeo DJ, Du S, Massenburg BB, Ng JJ, Wu M, Villavisanis DF, Fischer JP, Swanson JW, Bartlett SP, Taylor JA. Clinical Research Fellowship Fosters Mentorship, Teamwork, and Productivity: Our 11-Year Experience With a Craniofacial Research Fellowship. J Craniofac Surg 2024:00001665-990000000-01390. [PMID: 38421207 DOI: 10.1097/scs.0000000000009978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/03/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION This study describes the development and explores the academic impact of a cleft and craniofacial research fellowship. MATERIALS AND METHODS Research and career outcomes from 3 cleft and craniofacial surgeons, 14 clinical fellows, and 25 research fellows between 2010 and 2023 were examined. Academic productivity was measured by the number of peer-reviewed publications indexed in PubMed and podium presentations at national/international meetings. Residency match statistics were recorded for eligible research fellows. RESULTS Over this 14-year period (11 with research fellows), the team produced 500 publications in 96 peer-reviewed journals, with 153 (31%) in Plastic and Reconstructive Surgery, 117 (23%) in the Journal of Craniofacial Surgery, and 32 (6%) in The Cleft Palate-Craniofacial Journal. Yearly publications increased from 15.3±7.6 per year (before fellowship) to 23.0±5.3 (with 1 fellow) to 38.3±12.9 (2 fellows) to 81.0±5.7 (3 fellows; P<0.001). There was a strong annual linear growth in publications since the beginning the research fellowship position (r=0.88, P<0.001). All (100%) clinical research fellows developed strong relationships with senior surgeons, and all who applied to plastic surgery residency matched a significantly higher success rate than the national average (P<0.05). CONCLUSION Implementing a structured cleft and craniofacial clinical research fellowship was associated with a broad impact across all cleft and craniofacial team members, as reflected by increased academic output and high match rates among fellows. The fellowship also strengthens the talent pipeline into plastic surgery by fostering meaningful mentor/mentee relationships and provides a model that can be adopted in both surgical and nonsurgical fields.
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Affiliation(s)
- Dominic J Romeo
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Steven Du
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Benjamin B Massenburg
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Jinggang J Ng
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Meagan Wu
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Dillan F Villavisanis
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - John P Fischer
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Jordan W Swanson
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Scott P Bartlett
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Jesse A Taylor
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
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Fereydooni A, Fisher AT, Mullis DM, Smith BK, Sgroi MD. Impact of Integrated Vascular Surgery Residency Training Pathway and Professional Development Time on Career Choice and Research Productivity. JOURNAL OF SURGICAL EDUCATION 2024; 81:295-303. [PMID: 38105151 DOI: 10.1016/j.jsurg.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/24/2023] [Accepted: 10/13/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE The limited availability of academic surgery positions has led to increased competition for these jobs. Integrated vascular surgery residency (IVSR) allows for earlier specialization, with some programs providing professional development time (PDT). We hypothesized that IVSR and PDT lead to academic employment and increased research productivity. DESIGN This is a retrospective study of vascular surgery fellowship (VSF) and IVSR graduates. SETTING Training, number of publications, H-index, NIH funding, and employment history were collected using institutional websites, Doximity, Scopus, PubMed, and NIH Research Portfolio Reporting. PARTICIPANTS After a review of the research protocol, the Association of Program Directors in Vascular Surgery (APDVS) provided a list of vascular surgery fellowship (VSF) and IVSR graduates. METHODS After review of the research protocol, the Association of Program Directors in Vascular Surgery (APDVS) provided a list of vascular surgery fellowship (VSF) and IVSR graduates. Training, number of publications, H-index, NIH funding, and employment history were collected using institutional websites, Doximity, Scopus, PubMed, and NIH Research Portfolio Reporting. RESULTS From 2013-2017, comparison of IVSR (n=131) to VSF (n=603) graduates showed that IVSR graduates were more likely to be women (38.17% vs 28.19%; p = 0.024), be MD graduates (99.24% vs 93.37%; p = 0.008), attended programs in the northeast (41.98% vs 27.5%; p < 0.001), have advanced degrees (13.74% vs 6.97%; p = 0.01) and graduate from larger programs (median 15 vs 14 faculty; p = 0.013). There was no significant difference in number of publications per trainee by the end of training (median 4 vs 3; P=0.61) or annual trend in average number of publications. After training, there was no significant difference in the type of practice, academic affiliation, practice region, publication number, H-index, NIH funding, level of academic appointment, or leadership positions. From 2013-2019, a comparison of IVSR graduates with (n=32) and without PDT (n=190) demonstrated that those with PDT were more likely to be women (53.13% vs 34.74%; p = 0.038), have advanced degrees (28.12% vs 8.95%; p = 0.002), be at larger programs (median 14 vs 9 faculty; p < 0.001), train at a top 10 NIH funded program (65.62% vs 21.58%; p < 0.001) and publish more by the end of IVSR (median 9 vs 3; p < 0.001). Graduates with PDT were more likely to have academic employment and affiliation, a higher yearly publication rate, and greater H-index. CONCLUSION IVSR and VSF graduates have comparable academic employment and research productivity. However, PDT during IVSR correlates with an eventual academic career and greater research productivity. This study supports the importance of PDT in developing academic vascular surgeons. It remains necessary to continue both IVSR and VSF training paradigms as healthcare needs of the population are met through both academic and non-academic surgeons.
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Affiliation(s)
- Arash Fereydooni
- Division of Vascular and Endovascular Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California.
| | - Andrea T Fisher
- Division of Vascular and Endovascular Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Danielle M Mullis
- Division of Vascular and Endovascular Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Brigitte K Smith
- Division of Vascular Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Michael D Sgroi
- Division of Vascular and Endovascular Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California.
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Vasilopoulos T, Rawal S, Culley DJ, Fahy BG. Academic productivity and NIH funding for anesthesiology departmental chairs: A 15-year comparison. J Clin Anesth 2023; 91:111240. [PMID: 37660512 DOI: 10.1016/j.jclinane.2023.111240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/28/2023] [Accepted: 08/23/2023] [Indexed: 09/05/2023]
Abstract
STUDY OBJECTIVE This study evaluated whether there were improvements in the number of departmental National Institutes of Health (NIH) training grants and the academic productivity of departmental chairs in terms of NIH research funding and PubMed-cited publications when compared to chairs of the same departments in 2006. DESIGN Each chair was identified from the Society of Academic Associations of Academic Anesthesiology & Perioperative Medicine's Association of Academic Anesthesiology Chairs and entered into the NIH Research Portfolio Online Reporting Tools (RePORTER), PubMed, SCOPUS, and the National Provider Identifier Registry. MEASUREMENTS The number and funding amounts of training grants awarded to the department in 2010, 2015, and 2020 were obtained as well as the department's national ranking and total dollar amount for NIH funding in 2020. For the current chair cohort, total publications and m-quotient (h-index corrected for active research years) were recorded along with each chair's history of NIH grant funding. These data were compared to a previous study of anesthesiology chairs that reviewed funding and publications through 2006. MAIN RESULTS We analyzed data from 100 academic departments of anesthesiology and compared their scholarly activity relative to data gathered in 2006. In 2020, 52 of 100 departments of anesthesiology had evidence of NIH funding. There were not statistically significant (P > 0.05) differences in grants funding obtained by chairs between 2006 and 2020 with the exception that more chairs in 2006 had program or center grants. Median publications for chairs significantly increased from 35 in 2006 to 55 in 2021 (IRR = 1.5, 95% CI = 1.2-2.0, P = 0.003). Nineteen percent of chairs were female, which did not significantly differ from the proportion of women in the 2006 paper (15%, χ2 = 0.57, df = 1, P = 0.452). Of the male chairs, 90% were professors whereas 63% of female chairs were professors (χ2 = 8.8, df = 1, P = 0.003). Female chairs had fewer publications than male chairs (IRR = 1.8, 95% CI = 1.2-1.8, P = 0.002); however, m-quotients were not significantly different between men and women (P = 0.602). CONCLUSIONS When compared to 2006, department of anesthesiology chairs had more publications in 2021; however, NIH funding rates remained unchanged. The specialty had 19% female chairs, and those chairs had fewer publications than their male counterparts, though sex differences were attenuated using metrics that account for disparities in career length.
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Affiliation(s)
- Terrie Vasilopoulos
- Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610, USA; Department of Orthopaedics and Sports Medicine, University of Florida College of Medicine, PO Box 112727, Gainesville, FL 32611, USA
| | - Shiv Rawal
- Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610, USA
| | - Deborah J Culley
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Dulles 680, Philadelphia, PA 19104, USA
| | - Brenda G Fahy
- Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610, USA.
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Nofi CP, Roberts BK, Hansen L, Coppa GF, Patel V. Surgical Rehabilitation for Research Residents: A Pilot Program to Offset Surgical Skill Decay. JOURNAL OF SURGICAL EDUCATION 2023; 80:1385-1394. [PMID: 37567801 DOI: 10.1016/j.jsurg.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 06/13/2023] [Accepted: 07/16/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVE Select general surgery residents in the surgeon-scientist pipeline dedicate time away from clinical residency to conduct research. However, these research residents (RR) are vulnerable to operative skill decay. The aim of this study is to assess the feasibility of implementation and impact of an organized intervention designed to combat skill decay experienced by RR. DESIGN RR were enrolled in a pilot Surgical Rehabilitation Program (SRP). The SRP is comprised of 12 cadaver-based simulation sessions and supplemented with Fundamentals of Laparoscopic Surgery-based simulation workouts. The RR were integrated with the clinical residents (CR) during the cadaver sessions and were subsequently performance tested, surveyed, and interviewed. SETTING One academic general surgery residency program graduating 8 chief residents yearly in New York. PARTICIPANTS General surgery CR and residents on dedicated research years. RESULTS Data were collected for all local RR (n = 8) and 77% (n = 37) of CR. Local RR conducted research within the same health system that sponsors the residency. RR experienced gaps in training ranging from 2 to 4 years. All RR were permitted to moonlight on surgical services, however performed 0 operations and only 0.88 procedures on average per shift. Although RR performed similarly to level-matched CR on basic laparoscopic tasks, they required significantly more time on laparoscopic suturing-based skills than CR (p < 0.001). RR had significantly lower confidence levels precadaver sessions but gained confidence postcadaver sessions (p < 0.05), whereas CR confidence was unchanged. Regarding the SRP, qualitative interviews revealed major themes emphasizing the integration of RR, exposure to CR and faculty, technical skill development, maintenance of surgical know-how, and improved confidence for RR. CONCLUSIONS The implementation of such structured interventions, like our SRP, aimed at supporting RR over gap years is essential to help residents maintain skills and confidence needed to achieve their goals of becoming surgeon scientists.
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Affiliation(s)
- Colleen P Nofi
- Northwell North Shore University Hospital/Long Island Jewish Medical Center Department of Surgery, Manhasset, New York.
| | - Bailey K Roberts
- Northwell North Shore University Hospital/Long Island Jewish Medical Center Department of Surgery, Manhasset, New York
| | - Laura Hansen
- Northwell North Shore University Hospital/Long Island Jewish Medical Center Department of Surgery, Manhasset, New York; Zucker School of Medicine at Hofstra/Northwell Department of Surgery, Hempstead, New York
| | - Gene F Coppa
- Northwell North Shore University Hospital/Long Island Jewish Medical Center Department of Surgery, Manhasset, New York; Zucker School of Medicine at Hofstra/Northwell Department of Surgery, Hempstead, New York
| | - Vihas Patel
- Northwell North Shore University Hospital/Long Island Jewish Medical Center Department of Surgery, Manhasset, New York; Zucker School of Medicine at Hofstra/Northwell Department of Surgery, Hempstead, New York
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Egan CE, Lee YJ, Stratigis JD, Ku J, Greenberg JA, Beninato T, Zarnegar R, Fahey TJ, Agrusa CJ, Finnerty BM. An Original Study: Is There an Optimal Time to Complete Dedicated Research During Surgical Residency? Twelve Years of Research Experience After PGY2 or PGY3. JOURNAL OF SURGICAL EDUCATION 2023; 80:1207-1214. [PMID: 37442697 DOI: 10.1016/j.jsurg.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/01/2023] [Accepted: 06/11/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE We aimed to determine if there is an optimal time to complete dedicated research during surgical residency. BACKGROUND Research is an integral part of academic general surgical residency, and dedicated research usually occurs after the 2nd or 3rd post-graduate year (PGY). The timing of dedicated research and its association with resident productivity, self-assessed competency (including technical skills), and fellowship match is not known. METHODS PubMed was queried for publications resulting after dedicated research time for graduating surgical residents at a single institution from 2010 to 2021. Graduates were surveyed about their research experience and placed into 2 groups: research after PGY2 or PGY3. RESULTS Sixty-six of 91 (73%) graduating residents completed dedicated research (after PGY2, n=28; after PGY3, n=38). Median number of total and first author publications was similar between groups; however, research after PGY2 was associated with an increased number of basic science publications by fellowship application deadlines (PGY2: 1.0[0-13] vs PGY3: 0.0[0-6], p=0.02). With a 79% survey response rate, there were no differences in self-assessed competencies upon return from research between cohorts. Most surveyed residents matched at their top fellowship choice (PGY2:70% vs PGY3:62%, p=0.77). CONCLUSIONS Research after PGY2 or PGY3 had no association with residents' total number of publications, self-assessed competency, or rates of matching at first choice fellowship. As research after PGY2 had an increased number of basic science publications by time of fellowship application, surgical residents applying to fellowships that highly value basic science research may benefit from completing dedicated research after PGY2.
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Affiliation(s)
- Caitlin E Egan
- Department of Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York.
| | - Yeon Joo Lee
- Department of Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York
| | - John D Stratigis
- Department of Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York
| | - Joyce Ku
- Department of Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York
| | - Jacques A Greenberg
- Department of Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York
| | - Toni Beninato
- Department of Surgery, Rutgers-Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Rasa Zarnegar
- Department of Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York
| | - Thomas J Fahey
- Department of Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York
| | - Christopher J Agrusa
- Department of Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York
| | - Brendan M Finnerty
- Department of Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York
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Narahari AK, Chandrabhatla AS, Fronk E, White S, Mandava S, Jacobs-El H, Mehaffey JH, Tribble CG, Roeser M, Kern J, Kron IL, Schirmer B. Postdoctoral National Institutes of Health F32 Grants: Broken Pipeline in the Development of Surgeon-Scientists. Ann Surg 2023; 278:328-336. [PMID: 37389551 PMCID: PMC10495188 DOI: 10.1097/sla.0000000000005956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
OBJECTIVE We examined trainees in surgery and internal medicine who received National Institutes of Health (NIH) F32 postdoctoral awards to determine their success rates in obtaining future NIH funding. BACKGROUND Trainees participate in dedicated research years during residency (surgery) and fellowship (internal medicine). They can obtain an NIH F32 grant to fund their research time and have structured mentorship. METHODS We collected NIH F32 grants (1992-2021) for Surgery Departments and Internal Medicine Departments from NIH RePORTER, an online database of NIH grants. Nonsurgeons and noninternal medicine physicians were excluded. We collected demographic information on each recipient, including gender, current specialty, leadership positions, graduate degrees, and any future NIH grants they received. A Mann-Whitney U test was used for continuous variables, and a χ 2 test was utilized to analyze categorical variables. An alpha value of 0.05 was used to determine significance. RESULTS We identified 269 surgeons and 735 internal medicine trainees who received F32 grants. A total of 48 surgeons (17.8%) and 339 internal medicine trainees (50.2%) received future NIH funding ( P < 0.0001). Similarly, 24 surgeons (8.9%) and 145 internal medicine trainees (19.7%) received an R01 in the future ( P < 0.0001). Surgeons who received F32 grants were more likely to be department chair or division chiefs ( P =0.0055 and P < 0.0001). CONCLUSIONS Surgery trainees who obtain NIH F32 grants during dedicated research years are less likely to receive any form of NIH funding in the future compared with their internal medicine colleagues who received F32 grants.
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Affiliation(s)
- Adishesh K. Narahari
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | | | - Emily Fronk
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Simon White
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Shreya Mandava
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Hannah Jacobs-El
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - J. Hunter Mehaffey
- Department of Cardiovascular and Thoracic Surgery, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Curtis G. Tribble
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Mark Roeser
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - John Kern
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Irving L. Kron
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Bruce Schirmer
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
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Aziz H, Brown AC, Alvi S, Karamchandani M, Majumdar M, Sullivan ME, Bawazeer MA. Perceptions of General Surgery Program Leadership and Residents on Research Sabbatical. J Surg Res 2023; 289:152-157. [PMID: 37119616 DOI: 10.1016/j.jss.2023.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/11/2023] [Accepted: 03/25/2023] [Indexed: 05/01/2023]
Abstract
INTRODUCTION The incorporation of a 1-y- or 2-y research period during general surgery residency is increasingly common in many academic programs, yet often, it is heterogeneously structured and ill-defined. This survey-based observational study aimed to characterize the perceptions of general surgery program directors (PDs) and residents regarding an in-training, dedicated research sabbatical. METHODS Two surveys were conducted using Qualtrics software. One survey was sent to general surgery residency PDs, and the other was sent to general surgery residents currently on a research sabbatical. The primary aim of the survey was to assess the PDs' and research residents' perceptions of the research sabbatical. RESULTS Seven hundred and fifty-two surveys were analyzed, of which 120 were from PDs and 632 from research residents. Among the residents, 44.1% felt that the research time delayed their surgical training. Regarding research funding, 46.7% of the responding residents said that their residency program funded their research, 30.9% said they acquired funding independently, and 19.1% said that it came from a combination of residency program and independent funding. Finally, regarding how residents found their research opportunity, 42.7% said they found it independently and 53.3% said their program provided it. CONCLUSIONS Research sabbaticals during residency may be considered essential to academic development. However, in this survey-based study, perceptions of research time and its structure varied greatly between PDs and residents. An intentional push toward developing guidelines for research sabbaticals may benefit residency program leadership and residents.
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Affiliation(s)
- Hassan Aziz
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
| | - Alyssa C Brown
- United States Air Force, Sheppard Air Force Base, Wichita Falls, Texas
| | - Saba Alvi
- Department of Surgery, Tufts Medical Center, Boston, Massachusetts
| | | | - Monica Majumdar
- Department of Surgery, Tufts Medical Center, Boston, Massachusetts
| | - Maura E Sullivan
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
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11
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The Impact of Dedicated Research Years During Residency Upon Continued Academic Productivity of Plastic Surgeons. J Craniofac Surg 2023; 34:103-108. [PMID: 35968949 DOI: 10.1097/scs.0000000000008916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/29/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND This study explored the impact of dedicated research year(s) on long-term research productivity and career choices of plastic surgeons as academicians. METHODS Scopus and Web of Science were accessed in September 2020 to collate publications and H indexes of alumni who graduated from integrated plastic surgery residency programs from 2011 to 2020. Public profiles were utilized to determine academic status. Corresponding data were grouped by residency program type (traditional programs without required research, programs with one required research year, and a single program with variable research years). Unpaired t tests and 1-way analysis of variance were conducted to compare average H indexes and publication counts of alumni from each group. χ 2 tests analyzed differences in academic statuses. RESULTS Alumni who completed one required research year published significantly more with a higher H index compared with those from traditional programs. Similar results were found among alumni who completed 2 research years compared with 0 or 1 year within a single program. Residents who completed one required research year were more likely to hold dual academic and nonacademic positions after graduation compared with their traditional counterparts. However, there was no statistical difference in academic status observed for surgeons who graduated from the program with variable research years. CONCLUSIONS Participating in research year(s) during residency is predictive of ongoing academic productivity of surgeons within the first 10 years of completion of residency. This becomes important for training craniofacial surgeons, the majority of whom practice in academic settings.
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Chakhtoura M, Karam E, Akl EA, El Rassi R, Honein-AbouHaidar G. Research fellowship in a Lebanese academic medical center: What does it take to shift from an informal to a formal program? PLoS One 2022; 17:e0278576. [PMID: 36455060 PMCID: PMC9714842 DOI: 10.1371/journal.pone.0278576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 11/18/2022] [Indexed: 12/05/2022] Open
Abstract
Research fellowship programs help medical graduates acquire research skills for an academic career. While our institution employed a large number of research fellows, it did not offer them a formal training program. This study aimed to assess the views of fellows and their mentors regarding the current research fellowship program, and to seek their suggestions for a formal training program at our medical center. We conducted a qualitative descriptive study using both focus group discussions and individual interviews with research fellows, and individual interviews with their mentors. We recruited all eligible participants by email. We collected data in person and analyzed it thematically. We followed the consolidated criteria for reporting of qualitative research (COREQ) checklist. A total of 17 research fellows and 17 mentors participated in the study. Participants described the current non-formal program and proposed suggestions for a formal training program. The identification of available vacant positions and the recruitment process followed an unstructured approach, through networking with mentors and previous fellows. Although there is a formal contract, there is no job description, and no definition of roles, responsibilities and rights. Some fellows get the opportunity of being involved in all aspects of research and benefit from a favorable mentor-mentee relationship. Conversely, others struggle with authorship and with the projects allocated to them, some being "non-research" related. Not all fellows end up publishing their projects. Participants provided suggestions to shift into a formal training, including measures to improve on the recruitment process of fellows, defining roles and exposure to all aspects of research. Research fellows are eager to learn, but the currently available program is unstructured. They need a formal training program that meets their expectations, one that offers equitable learning opportunities and benefits to all.
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Affiliation(s)
- Marlene Chakhtoura
- Clinical Research Institute, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Elsa Karam
- Clinical Research Institute, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Elie A. Akl
- Clinical Research Institute, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rola El Rassi
- Clinical Research Institute, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Ried M, Walles T, Hofmann HS. Entwicklung der akademischen Thoraxchirurgie in Deutschland. Zentralbl Chir 2022. [DOI: 10.1055/a-1857-5902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
ZusammenfassungDie Thoraxchirurgie ist in Deutschland vornehmlich an außeruniversitären thoraxchirurgischen Kliniken abgebildet und nur an verhältnismäßig wenigen Universitätskliniken klinisch als
eigenständige Abteilung oder Klinik und wissenschaftlich als W2- oder W3-Professur etabliert. Infolgedessen ist die Gewinnung von fachärztlichem Nachwuchs und insbesondere die
Generierung von akademisch tätigen Thoraxchirurgen als Kontaktpersonen für Forschende aus den unterschiedlichen Bereichen der Lebens- und Ingenieurwissenschaften sowie für die
Weiterentwicklung des Fachgebiets Thoraxchirurgie deutlich schwieriger als in anderen chirurgischen Fächern. In den medizinischen Fakultäten stehen die Lehre, Forschung und
Patientenversorgung gleichberechtigt nebeneinander. Für die Übernahme dieser Aufgaben durch Thoraxchirurgen werden Konzepte zum Ausbau und der Förderung der akademischen
Thoraxchirurgie in der deutschen Hochschulmedizin benötigt. Ein strukturiertes Curriculum Akademische Thoraxchirurgie kann zusätzlich zu Mentorenprogrammen, Fördermöglichkeiten und
zusätzlichen Freiräumen für die Forschung bzw. Lehre die akademische Karriere in der Thoraxchirurgie unterstützen.
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Affiliation(s)
- Michael Ried
- Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Thorsten Walles
- Klinik für Herz- und Thoraxchirurgie, Abteilung Thoraxchirurgie, Otto-von-Guericke-Universität Magdeburg Medizinische Fakultät, Magdeburg,
Deutschland
| | - Hans-Stefan Hofmann
- Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland
- KH Barmehrzige Brüder Regensburg, Klinik für Thoraxchirurgie, Regensburg, Deutschland
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Zhang GQ, Hicks CW. Outcomes 101: A brief guide for conducting an outcomes research project as a surgeon-scientist in training. Am J Surg 2022; 224:e1-e4. [PMID: 35317922 PMCID: PMC9853227 DOI: 10.1016/j.amjsurg.2022.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 01/22/2023]
Affiliation(s)
- George Q. Zhang
- Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - Caitlin W. Hicks
- Corresponding author. Johns Hopkins University School of Medicine, 600 North Wolfe Street, Halsted 668, Baltimore, MD, 21287, USA. (C.W. Hicks)
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Madayag RM, Sercy E, Berg GM, Banton KL, Carrick M, Lieser M, Tanner A, Bar-Or D. Are trauma research programs in academic and non-academic centers measured by equal standards? A survey of 137 level I trauma centers in the United States. Patient Saf Surg 2021; 15:34. [PMID: 34627343 PMCID: PMC8501921 DOI: 10.1186/s13037-021-00309-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/24/2021] [Indexed: 11/14/2022] Open
Abstract
Background American College of Surgeons level I trauma center verification requires an active research program. This study investigated differences in the research programs of academic and non-academic trauma centers. Methods A 28-question survey was administered to ACS-verified level I trauma centers in 11/12/2020–1/7/2021. The survey included questions on center characteristics (patient volume, staff size), peer-reviewed publications, staff and resources dedicated to research, and funding sources. Results The survey had a 31% response rate: 137 invitations were successfully delivered via email, and 42 centers completed at least part of the survey. Responding level I trauma centers included 36 (86%) self-identified academic and 6 (14%) self-identified non-academic centers. Academic and non-academic centers reported similar annual trauma patient volume (2190 vs. 2450), number of beds (545 vs. 440), and years of ACS verification (20 vs. 14), respectively. Academic centers had more full-time trauma surgeons (median 8 vs 6 for non-academic centers) and general surgery residents (median 30 vs 7) than non-academic centers. Non-academic centers more frequently ranked trauma surgery (100% vs. 36% academic), basic science (50% vs. 6% academic), neurosurgery (50% vs. 14% academic), and nursing (33% vs. 0% academic) in the top three types of studies conducted. Academic centers were more likely to report non-profit status (86% academic, 50% non-academic) and utilized research funding from external governmental or non-profit grants more often (76% vs 17%). Conclusions Survey results suggest that academic centers may have more physician, resident, and financial resources available to dedicate to trauma research, which may make fulfillment of ACS level I research requirements easier. Structural and institutional changes at non-academic centers, such as expansion of general surgery resident programs and increased pursuit of external grant funding, may help ensure that academic and non-academic sites are equally equipped to fulfill ACS research criteria. Supplementary Information The online version contains supplementary material available at 10.1186/s13037-021-00309-2.
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Affiliation(s)
- Robert M Madayag
- Trauma Services Department, St. Anthony Hospital, Lakewood, CO, USA
| | - Erica Sercy
- Trauma Research Department, Swedish Medical Center, Englewood, CO, USA
| | - Gina M Berg
- Trauma Services Department, Wesley Medical Center, Wichita, KS, USA
| | - Kaysie L Banton
- Trauma Services Department, Swedish Medical Center, Englewood, CO, USA
| | - Matthew Carrick
- Trauma Services Department, Medical City Plano, Plano, TX, USA
| | - Mark Lieser
- Trauma Services Department, Research Medical Center, Kansas City, MO, USA
| | - Allen Tanner
- Trauma Services Department, Penrose Hospital, Colorado Springs, CO, USA
| | - David Bar-Or
- Trauma Research Department, Swedish Medical Center, Englewood, CO, USA. .,Injury Outcomes Network and Trauma Research, LLC, 501 E Hampden Ave, Englewood, CO, 80113, USA.
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Factors Affecting Outcomes of Craniofacial Clinical Trials. J Craniofac Surg 2021; 32:2484-2486. [PMID: 34705392 DOI: 10.1097/scs.0000000000007747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aims to provide a cross-sectional view of craniofacial trials and to identify factors associated with completion, publication, and trial longevity. MATERIALS AND METHODS This is a cross-sectional study of cleft and craniofacial clinical trials registered with ClinicalTrials.gov between September 1999 and April 2020. Predictor variables included funding source, trial design, trial location, number of recruitment sites, and investigator specialty.Study outcomes were completion status, publication status, and trial duration. Univariate comparisons and multivariate regression models were calculated for each outcome. RESULTS The final sample included 179 clinical trials pertaining to craniofacial care. Nearly all trials were single-center (86.5%), and roughly half of trials were interventional (57.0%) or conducted in the United States (40.5%). No single specialty predominated, although plastic surgery (13.4%) was the most common investigator specialty. The completion rate was 82.7%, the publication rate was 40.8%, and the mean trial duration was 39.1 months. Interventional design (odds ratio = 0.30, P = 0.02) and United States location (odds ratio = 0.15, P < 0.01) were each independently associated with lower odds of trial completion. Trial longevity was independently associated with the National Institute of Health-funding (P < 0.01) and multicenter design (P < 0.01). CONCLUSIONS Craniofacial trials are multidisciplinary and have a high rate of completion. Although most existing trials were conducted at only a single-center, multicenter efforts significantly increased trial longevity without compromising completion and publication rates. Given the diverse array of conditions and lines of inquiry that compose craniofacial care, it is reassuring that collaboration did not negatively affect trial outcomes.
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Kane WJ, Berry PS, Denton AH, Schroen AT. Attainment of an Additional Graduate Degree Is Associated With Sustained Scholarly Activity Beyond Surgical Residency. JOURNAL OF SURGICAL EDUCATION 2021; 78:1189-1196. [PMID: 33349567 DOI: 10.1016/j.jsurg.2020.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/12/2020] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To determine whether attainment of an additional graduate-level degree during general surgery residency, such as an MSc, MPH, MBA, or PhD, is associated with increased research productivity beyond completion of training. DESIGN Observational cohort study comparing publication productivity of general surgery residency graduates who did and did not obtain a degree. PubMed queries and the Web of Science Core Collection were used to capture publication metrics. Graduate characteristics, including degree attainment, were obtained from an institutional database. Practice webpages were reviewed to designate an academic surgical practice, defined as an assistant, associate, or full professorship appointment. SETTING Single academic general surgery residency program. PARTICIPANTS Categorical general surgery residency graduates who performed at least 1 year of dedicated research. RESULTS 1768 total publications, representing 1500 unique publications, were authored by 54 residents, of which 18 (33.3%) residents attained an additional graduate-level degree during dedicated research. 1369 (91.3%) publications had identifiable Journal Impact Factors and citation data. Degree attainers were more likely to be female (55.6% vs. 25.0%, p = 0.03) and spend more time in dedicated research (mean 2.2 vs. 1.8 years, p = 0.02). Overall, degree attainers published more frequently during residency (median 4.4 vs. 2.1 publications/year, p < 0.001) and fellowship (median 2.0 vs. 1.0 publications/year, p = 0.046). Analysis of the first 4 post-training years demonstrated degree attainers produced 1.2 more publications per year among all graduates (2.3 vs. 1.1 publications/year, p = 0.02) and 1.6 more publications per year among graduates practicing academic surgery (3.3 vs. 1.7 publications/year, p = 0.02). There were no differences in the Journal Impact Factor or publication citations per year among degree and nondegree attaining graduates. CONCLUSIONS Attainment of an additional graduate-level degree was associated with increased research productivity that was sustained beyond surgical residency. Programs with the goal of training academic surgeons should support professional degrees during dedicated research years.
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Affiliation(s)
- William J Kane
- Department of Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Puja S Berry
- Department of Colorectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - Andrea H Denton
- Claude Moore Health Sciences Library, University of Virginia, Charlottesville, Virginia
| | - Anneke T Schroen
- Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
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Abstract
Thoracic surgery has evolved into an independent discipline out of general surgery practice over the past decades. The development of the field of thoracic surgery was generated from surgeons being motivated to move this field forward by constant analysis and critical appraisal and review of current practice, as well as identification of new research approaches as the pool and generator of innovation. For this purpose, scientific skills are needed that are currently not covered during the surgical training. In the present overview, we will try to summarize important factors for an academic career, although none of these recommendations are validated and also not realistic to be uniquely applied to every geographical setting. Several key factors will be described being necessary for pursuing basic science, translational, and clinical research as a surgeon scientist introducing “from bench to bedside” research ideas into clinic and “from bedside to bench” bringing important clinical problems back to the lab.
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Affiliation(s)
- Isabelle Opitz
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Thorsten Walles
- Department of Thoracic Surgery, University Medicine Magdeburg, Magdeburg, Germany
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Karimov Z, Kazim SF, Schmidt M, Gandhi C, Vanderhooft J, Cole C, Stein A, Al-Mufti F, Bowers C. Rapid exponential increase in neurosurgery departmental scholarly output following an intensive research initiative. Postgrad Med J 2021; 98:239-245. [PMID: 33632761 DOI: 10.1136/postgradmedj-2020-139133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/28/2020] [Accepted: 12/03/2020] [Indexed: 11/04/2022]
Abstract
There has been extensive research into methods of increasing academic departmental scholarly activity (DSA) through targeted interventions. Residency programmes are responsible for ensuring sufficient scholarly opportunities for residents. We sought to discover the outcomes of an intensive research initiative (IRI) on DSA in our department in a short-time interval. IRI was implemented, consisting of multiple interventions, to rapidly produce an increase in DSA through resident/medical student faculty engagement. We compare pre-IRI (8 years) and post-IRI (2 years) research products (RP), defined as the sum of oral presentations and publications, to evaluate the IRI. The study was performed in 2020. The IRI resulted in an exponential increase in DSA with an annual RP increase of 350% from 2017 (3 RP) to 2018 (14 RP), with another 92% from 2018 (14 RP) to 2019 (27 RP). RP/year exponentially increased from 2.1/year to 10.5/year for residents and 0.5/year to 10/year for medical students, resulting in a 400% and 1900% increase in RP/year, respectively. The common methods in literature to increase DSA included instituting protected research time (23.8%) and research curriculum (21.5%). We share our department's increase in DSA over a short 2-year period after implementing our IRI. Our goal in reporting our experience is to provide an example for departments that need to rapidly increase their DSA. By reporting the shortest time interval to achieve exponential DSA growth, we hope this example can support programmes in petitioning hospitals and medical colleges for academic support resources.
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Affiliation(s)
- Zafar Karimov
- Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USA
| | - Syed Faraz Kazim
- Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Meic Schmidt
- Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Chirag Gandhi
- Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USA
| | - Jordan Vanderhooft
- Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USA
| | - Chad Cole
- Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USA
| | - Alan Stein
- Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USA
| | - Fawaz Al-Mufti
- Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USA
| | - Christian Bowers
- Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
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Huffman EM, Anderson TN, Choi JN, Smith BK. Why the Lab? What is Really Motivating General Surgery Residents to Take Time for Dedicated Research. JOURNAL OF SURGICAL EDUCATION 2020; 77:e39-e46. [PMID: 32768383 DOI: 10.1016/j.jsurg.2020.07.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/01/2020] [Accepted: 07/19/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Over one third of general surgery residents interrupt their clinical training to pursue dedicated research time (DRT), which has financial implications for programs and residents. Studies have examined the impact of DRT on academic outcomes, but little is known about why residents pursue DRT. Therefore, this study aimed to examine resident motivations regarding DRT in order to gain an understanding of resident goals and challenges surrounding this phase of training. DESIGN Surgical residents currently participating in DRT and residents considering completing DRT were recruited to participate. Members of the research team at each institution conducted interviews and focus groups, which were recorded and transcribed. Data was analyzed using the qualitative method of open and focused coding. Identified themes guided the development of a conceptual framework. SETTING Interviews and focus groups were held at three geographically diverse US academic health centers. PARTICIPANTS Twenty-one surgery residents participated. RESULTS Reasons for pursuing DRT fell into 1 of 3 themes: strategic career planning, professional development, and personal rejuvenation. Residents described the perceived need for publications or networking to enhance future competitiveness for desired fellowships or academic appointments. Residents also expressed the desire to have time for career exploration and to cultivate mentorship for their professional career. The need to take time off for more personal reasons, including burnout, was pervasive. Additionally, many in DRT felt under-supported in developing their research skills and expressed a desire for more formal instruction and guidance from mentors. CONCLUSIONS General surgery residents' motivations to pursue DRT are multifactorial. Professional development is a pervasive motivation and includes learning skills that can be applied to future research. Current DRT programs may be inadequate in supporting residents to achieve this goal. These results can be used to inform programmatic efforts to optimize DRT for residents and mentors alike.
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Affiliation(s)
| | - Tiffany N Anderson
- Stanford University, Department of Surgery, Goodman Surgical Education Center, Stanford, California
| | - Jennifer N Choi
- Indiana University, Department of Surgery, Indianapolis, Indiana
| | - Brigitte K Smith
- University of Utah, Department of Surgery, Division of Vascular Surgery, Salt Lake City, Utah
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Zuo KJ, Meng Y, Gordon L, Saun TJ, Mazine A, Ahuja CS, Lipsman N, Rutka JT, Fehlings MG. Navigating the Postgraduate Research Fellowship: A Roadmap for Surgical Residents. J Surg Res 2020; 256:282-289. [PMID: 32712442 DOI: 10.1016/j.jss.2020.06.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/03/2020] [Accepted: 06/16/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND To preserve the future of surgical innovation, opportunities for surgical residents to receive structured research training are paramount. The objective of this article is to help surgical residents navigate a research fellowship by overviewing key topics such as choosing an area of focus and supervisor, applying for external funding, transitioning away from clinical duties, managing intellectual property, integrating family planning, and incorporating research experience into independent career development. MATERIALS AND METHODS Using the framework of the University of Toronto's graduate degree-awarding Surgeon-Scientist Training Program, the authors outline key considerations, decisions, and pearls for surgical residents considering or currently enrolled in a full-time research fellowship training program. RESULTS Full-time research fellowships offer a unique opportunity for residents interested in an academic career. Such full-time research fellowships away from clinical duties allow surgical trainees to focus on developing key research competencies, including how to generate hypotheses, apply research methodology, gain experience presenting and publishing manuscripts, and ultimately apply these skills as independent investigators to improve patient and population health. Research fellowships may also be an opportunity to develop intellectual property or facilitate family planning. Practical tips are provided for the transition back into clinical training and how to effectively market one's research skills for career advancement. CONCLUSIONS The authors outline key considerations, decisions, and pearls for surgical residents considering or currently enrolled in a full-time research fellowship training program. By adhering to the principles highlighted in this article, residents will be able to successfully navigate a full-time research fellowship to optimize their intellectual development, maximize their academic productivity, and facilitate their transition into an independent investigator.
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Affiliation(s)
- Kevin J Zuo
- Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ying Meng
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Lauren Gordon
- Division of Vascular Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; International Centre for Surgical Safety, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Tomas J Saun
- Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Amine Mazine
- Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Christopher S Ahuja
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Nir Lipsman
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - James T Rutka
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Cell Biology, SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael G Fehlings
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Division of Genetics and Development, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; Spinal Program, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
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Andriole DA, Klingensmith ME, Fields RC, Jeffe DB. Is Dedicated Research Time During Surgery Residency Associated With Surgeons' Future Career Paths?: A National Study. Ann Surg 2020; 271:590-597. [PMID: 30829693 PMCID: PMC6401322 DOI: 10.1097/sla.0000000000003015] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We examined associations between participation in ≥1 year of research during general surgery residency and each of full-time academic-medicine faculty appointment and mentored-K and/or Research Project Grant (RPG, including R01 and other) awards. SUMMARY BACKGROUND DATA Many surgeons participate in ≥1 year of research during residency; however, the relationship between such dedicated research during general surgery residency and surgeons' career paths has not been investigated in a national study. METHODS We analyzed deidentified data through August 2014 from the Association of American Medical Colleges, American Board of Medical Specialties, and the National Institutes of Health Information for Management, Planning, Analysis, and Coordination II grants database for 1997 to 2004 US medical-school graduates who completed ≥5 years of general surgery graduate medical education (GME) and became board-certified surgeons. Using multivariable logistic regression models, we identified independent predictors of faculty appointment and K/RPG award, reporting adjusted odds ratios (AOR) and 95% confidence intervals (CI) significant at P < 0.05. RESULTS Of 5328 board-certified surgeons, there were 1848 (34.7%) GME-research participants, 1658 (31.1%) faculty appointees, and 58 (1.1%) K/RPG awardees. Controlling for sex, debt, MD/PhD graduation, and other variables, GME-research participants were more likely to have received faculty appointments (AOR 1.790; 95% CI 1.573-2.037) and federal K/RPG awards (AOR 4.596; 95% CI 2.355-8.969). CONCLUSIONS Nationally, general surgery GME-research participation was independently associated with faculty appointment and K/RPG award receipt. These findings serve as benchmarks for general surgery residency programs aiming to prepare trainees for careers as academicians and surgeon-scientists.
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Affiliation(s)
- Dorothy A Andriole
- Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Mary E Klingensmith
- Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Ryan C Fields
- Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Donna B Jeffe
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
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Kim S, Li B, Rosoklija I, Johnson EK, Yerkes E, Chu DI. Federal research funding and academic productivity in pediatric urology: from early career to research independence. J Pediatr Urol 2019; 15:233-239. [PMID: 30928295 DOI: 10.1016/j.jpurol.2019.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 02/26/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Federal grants from the National Institutes of Health (NIH) or Agency for Healthcare Research and Quality (AHRQ) are crucial for early career physician-scientists. Federal funding success has been explored in other surgical specialties, but has not been evaluated in pediatric urology. OBJECTIVE To characterize factors associated with receipt of federal grants, hypothesizing that pediatric urologists who were have advanced research degree(s) were more likely to be federally funded. STUDY DESIGN All pediatric fellowship graduates from 1985-2016 listed on the Societies for Pediatric Urology and institutional websites were queried using the NIH Research Portfolio Online Reporting Tools. Primary outcomes were successful receipt of federal grants and transition from mentor-based to independent funding. The secondary outcome was publication rate on PubMed as of November 2017. Covariables included advanced degree(s) (eg, PhD, MPH, MSc, etc), sex, and year of fellowship graduation (1985-2006 versus 2007-2016). RESULTS Of 445 pediatric urologists (73% male), 36 (8%) were federal grant recipients. Of 18 mentor-based awardees, 9 (50%) transitioned to independent awards. After adjusting for sex and year of fellowship graduation, having an advanced degree(s) was associated with funding success for mentor-based awards (hazard ratio [HR] 3.83 [95% confidence interval, 1.21-12.14], p = 0.02; Summary Table) and independent awards (HR 3.11 [1.21-8.02], p = 0.02), and with higher publication rates (incident rate ratio [IRR] 2.03 [1.43-2.87], p < 0.001). Recent training (2007-2016) was also associated with higher publication rates (IRR 2.70 [2.16-3.37], p < 0.001). DISCUSSION Among fellowship-trained pediatric urologists in North America between 1985 and 2016, the prevalence of federal grant recipients was 8%. Pediatric urologists who had an advanced educational degree were more likely to be a federally funded grant recipient and have a higher publication rate. CONCLUSIONS Fellowship programs should consider adding opportunities for self-selected applicants to pursue additional research training and degrees.
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Affiliation(s)
- S Kim
- Department of Surgery, Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - B Li
- Department of Surgery, Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Urology, Loyola University Medical Center, Chicago, IL, USA
| | - I Rosoklija
- Department of Surgery, Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - E K Johnson
- Department of Surgery, Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - E Yerkes
- Department of Surgery, Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - D I Chu
- Department of Surgery, Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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Bensken WP, Nath A, Heiss JD, Khan OI. Future Directions of Training Physician-Scientists: Reimagining and Remeasuring the Workforce. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:659-663. [PMID: 30640263 PMCID: PMC6483871 DOI: 10.1097/acm.0000000000002581] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In academic medicine, the attrition of the physician-scientist workforce has been significantly discussed for the past three decades, with substantial attention and funding targeted to stop this attrition and attempt to reinvigorate the workforce. Despite these concerns and efforts, the attrition has not been stopped or even significantly slowed, and thus a further understanding of the physician-scientist workforce is needed with a closer look at how this workforce is measured and quantified. Through reviewing three methods by which physician-scientists are identified and understood, limitations in these definitions arise, leading to the basic question: Who qualifies to be a physician-scientist? Answering this question may lead to developing more comprehensive and less restrictive approaches when qualifying and measuring the physician-scientist workforce and appreciating the varying contributions physicians make to research. Through suggesting an expanded appreciation of these research contributions, recognition of collaboration, and funding models that support both of these aspects, the authors hope to add to the conversation by challenging traditional approaches and encouraging movement toward forward-looking definitions that encourage and promote all physicians to engage with research. This reimagining of physician-scientists will result not just in a remeasuring of the workforce but, subsequently, in strengthening the clinical and translational research continuum as well.
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Affiliation(s)
- Wyatt P Bensken
- W.P. Bensken is a postbaccalaureate fellow, Medical Education Unit, Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland. A. Nath is clinical director and senior investigator, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland. J.D. Heiss is chair and residency program director, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland. O.I. Khan is director, Medical Education Unit, and fellowship program director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
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Dewane MP, Thomas DC, Longo WE, Yoo PS. Paying the Price: Understanding the Opportunity Cost of Dedicated Research Time during Surgical Training. Am Surg 2018. [DOI: 10.1177/000313481808401125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The pursuit of dedicated research time during surgical residency prolongs training and delays entry into practice. Currently, there is a lack of research quantifying the financial implication of this delay and trainees’ understanding of its impact on career earnings. An opportunity cost analysis was performed regarding the impact of delay due to training within general surgery and selected subspecialties. An anonymous survey was distributed to general surgery categorical junior trainees in 2017 at a large academic hospital in the Northeast to determine understanding and beliefs regarding dedicated training on career earnings. For all specialties analyzed, dedicated research time was shown to negatively affect career earnings. The net cost was highest among those intending to pursue cardiothoracic surgery and lowest for those intending to pursue surgical oncology. A total of 26 of 35 (74%) present research residents and clinical residents intending to perform dedicated research time responded to an anonymous survey. On average, survey respondents underestimated the impact of dedicated research time on career earnings by $1.4 million. Dedicated research time during general surgery residency carries a substantial opportunity cost to overall career earnings. General surgery residents lack understanding of both the direction and the magnitude of this opportunity cost.
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Affiliation(s)
- Michael P. Dewane
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Daniel C. Thomas
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Walter E. Longo
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Peter S. Yoo
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
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Eldredge TA, Harley SJD, Warren LR, Shenfine J. Doctor-doctor: the impact of early career higher degrees in surgical research. ANZ J Surg 2018; 88:820-822. [PMID: 30182413 DOI: 10.1111/ans.14552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Thomas A Eldredge
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Simon J D Harley
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Leigh R Warren
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Jonathan Shenfine
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Mayes LM, Wong CA, Zimmer S, Fernandez-Bustamante A, Bartels K. Gender differences in career development awards in United States' anesthesiology and surgery departments, 2006-2016. BMC Anesthesiol 2018; 18:95. [PMID: 30049265 PMCID: PMC6062945 DOI: 10.1186/s12871-018-0561-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 07/17/2018] [Indexed: 11/29/2022] Open
Abstract
Background Although the status of women in anesthesiology has advanced by many measures, obtaining career development funding remains challenging. Here, we sought to compare the characteristics of funded career development awards from the National Institutes of Health (NIH) between the specialties of anesthesiology and surgery. We hypothesized that the two groups differ in percentage of faculty with awards, gender distribution among principal investigators, as well as the number of awards promoting diversity. Methods The NIH grant-funding database RePORT was queried for career development awards for the years 2006–2016 using the filters “Anesthesiology” and “Surgery.” Grants were characterized based on the gender of the principal investigator and whether the funding opportunity announcement indicated promotion of underrepresented minorities (URM). The 2016 Association of American Medical Colleges (AAMC) report on “Distribution of U.S. Medical School Faculty by Sex and Rank” was used to adjust comparisons according to baseline gender distributions in anesthesiology and surgery departments. Cohorts were characterized using descriptive methods and compared using Chi-square or Fisher’s exact test. Results Based on our AAMC data query, in 2016, the number of women faculty members at the instructor or assistant professor level in U.S. medical schools was 2314 (41%) for anesthesiology and 2281 (30%) for surgery. Between 2006 and 2016, there were 88 career development grants awarded to investigators in anesthesiology departments compared to 261 in surgery departments. Of the grantees in each specialty, 29 (33%) were women in anesthesiology and 72 (28%) in surgery (P = 0.344). Awards to promote URM were identified for two grants (2%) in anesthesiology and nine grants (3%) in surgery (P = 0.737). Faculty members in surgery were more likely to receive an award than in anesthesiology (P < 0.0001), and women were less likely to receive an award than men (P = 0.026). Conclusions The major difference between US anesthesiology and surgery departments is that the number of faculty career development awards is significantly higher in surgery departments. Future efforts should aim to identify the reasons for such differences in order to inform strategies that can improve the likelihood for junior faculty members to receive career development funding.
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Affiliation(s)
- Lena M Mayes
- Department of Anesthesiology, University of Colorado School of Medicine, 12401 E. 17th Avenue Leprino Office Building, 7th Floor, MS B-113, Aurora, CO, 80045, USA
| | - Cynthia A Wong
- Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Shanta Zimmer
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ana Fernandez-Bustamante
- Department of Anesthesiology, University of Colorado School of Medicine, 12401 E. 17th Avenue Leprino Office Building, 7th Floor, MS B-113, Aurora, CO, 80045, USA
| | - Karsten Bartels
- Department of Anesthesiology, University of Colorado School of Medicine, 12401 E. 17th Avenue Leprino Office Building, 7th Floor, MS B-113, Aurora, CO, 80045, USA.
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Skube SJ, Arsoniadis EG, Jahansouz C, Novitsky S, Chipman JG. Supplementing Resident Research Funding Through a Partnership With Local Industry. JOURNAL OF SURGICAL EDUCATION 2018; 75:907-910. [PMID: 29361506 DOI: 10.1016/j.jsurg.2018.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/15/2017] [Accepted: 01/03/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To develop a model for the supplementation of resident research funding through a resident-hosted clinical immersion with local industry. DESIGN Designated research residents hosted multiple groups of engineers and business professionals from local industry in general surgery-focused clinical immersion weeks. The participants in these week-long programs are educated about general surgery and brought to the operating room to observe a variety of surgeries. SETTING This study was performed at the University of Minnesota, in Minneapolis, Minnesota, at a tertiary medical center. PARTICIPANTS Ten designated research residents hosted general surgery immersion programs. Fifty-seven engineers and business professionals from 5 different local biomedical firms have participated in this program. RESULTS General surgery research residents (in collaboration with the University of Minnesota's Institute for Engineering in Medicine) have hosted 9 clinical immersion programs since starting the collaborative in 2015. Immersion participant response to the experiences was very positive. Two full-time resident research positions can be funded annually through participation in this program. CONCLUSIONS With decreasing funding available for surgical research, particularly resident research, innovative ways to fund resident research are needed. The general surgery clinical immersion program at the University of Minnesota has proven its value as a supplement for resident research funding and may be a sustainable model for the future.
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Affiliation(s)
- Steven J Skube
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
| | | | - Cyrus Jahansouz
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Sherri Novitsky
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Jeffrey G Chipman
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
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D'Angelo ALD, D'Angelo JD, Rogers DA, Pugh CM. Faculty perceptions of resident skills decay during dedicated research fellowships. Am J Surg 2018; 215:336-340. [DOI: 10.1016/j.amjsurg.2017.11.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/29/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
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Grova MM, Yang AD, Humphries MD, Galante JM, Salcedo ES. Dedicated Research Time During Surgery Residency Leads to a Significant Decline In Self-Assessed Clinical Aptitude and Surgical Skills. JOURNAL OF SURGICAL EDUCATION 2017; 74:980-985. [PMID: 28533183 DOI: 10.1016/j.jsurg.2017.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/26/2017] [Accepted: 05/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The surgical community commonly perceives a decline in surgical and patient care skills among residents who take dedicated time away from clinical activity to engage in research. We hypothesize that residents perceive a decline in their skills because of dedicated research time. SETTING UC Davis Medical Center, Sacramento, CA, an institutional tertiary care center. PARTICIPANTS General surgery residents and graduates from UC Davis general surgery residency training program, who had completed at least 1 year of research during their training. A total of 35 people were asked to complete the survey, and 19 people submitted a completed survey. DESIGN Participants were invited to complete an online survey. Factors associated with the decline in skills following their research years were examined. All statistical analyses were performed with IBM SPSS Statistics software. RESULTS A total of 19 current or former general surgery residents responded to the survey (54% response rate). Overall, 42% described their research as "basic science." Thirteen residents (68%) dedicated 1 year to research, while the remainder spent 2 or more years. Basic science researchers were significantly more likely to report a decrease in clinical judgment (75% vs. 22%, p = 0.013) as well as a decrease in patient care skills (63% vs. 0%, p = 0.002). Residents who dedicated at least 2 years to research were more likely to perceive a decline in overall aptitude and surgical skills (100% vs. 46%, p = 0.02), and a decline in patient care skills (67% vs. 8%, p = 0.007). CONCLUSIONS Most residents who dedicate time for research perceive a decline in their overall clinical aptitude and surgical skills. This can have a dramatic effect on the confidence of these residents in caring for patients and leading a care team once they re-enter clinical training. Residents who engaged in 2 or more years of research were significantly more likely to perceive these problems. Further research should determine how to keep residents who are interested in academics from losing ground clinically while they are pursuing research training.
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Affiliation(s)
- Monica M Grova
- Department of Surgery, UC Davis School of Medicine, Sacramento, California.
| | - Anthony D Yang
- Department of Surgery, UC Davis School of Medicine, Sacramento, California; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Misty D Humphries
- Department of Surgery, UC Davis School of Medicine, Sacramento, California
| | - Joseph M Galante
- Department of Surgery, UC Davis School of Medicine, Sacramento, California
| | - Edgardo S Salcedo
- Department of Surgery, UC Davis School of Medicine, Sacramento, California
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Saadeh PB, Manjunath AK. Discussion: Academic Productivity, Knowledge, and Education in Plastic Surgery: The Benefit of the Clinical Research Fellow. Plast Reconstr Surg 2017; 140:850-851. [PMID: 28953740 DOI: 10.1097/prs.0000000000003731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Pierre B Saadeh
- New York, N.Y.,From the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine
| | - Amit K Manjunath
- New York, N.Y.,From the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine
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Academic Productivity of Accreditation Council for Graduate Medical Education-Accredited Critical Care Fellowship Program Directors. Crit Care Med 2017; 44:e1194-e1201. [PMID: 27495817 DOI: 10.1097/ccm.0000000000001962] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Academic productivity is an expectation for program directors of Accreditation Council for Graduate Medical Education-accredited subspecialty programs in critical care medicine. Within the adult critical care Accreditation Council for Graduate Medical Education-accredited programs, we hypothesized that program director length of time from subspecialty critical care certification would correlate positively with academic productivity, and primary field would impact academic productivity. DESIGN This study received Institutional Review Board exemption from the University of Florida. Data were obtained from public websites on program directors from all institutions that had surgery, anesthesiology, and pulmonary Accreditation Council for Graduate Medical Education-accredited subspecialty critical care training programs during calendar year 2012. Information gathered included year of board certification and appointment to program director, academic rank, National Institutes of Health funding history, and PubMed citations. RESULTS Specialty area was significantly associated with total (all types of publications) (p = 0.0002), recent (p < 0.0001), last author (p = 0.008), and original research publications (p < 0.0001), even after accounting for academic rank, years certified, and as a program director. These differences were most prominent in full professors, with surgery full professors having more total, recent, last author, and original research publications than full professors in the other critical care specialties. CONCLUSIONS This study demonstrates that one's specialty area in critical care is an independent predictor of academic productivity, with surgery having the highest productivity. For some metrics, such as total and last author publications, surgery had more publications than both anesthesiology and pulmonary, whereas there was no difference between the latter groups. This suggests that observed differences in academic productivity vary by specialty.
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Hu Y, Edwards BL, Hu K, Brooks KD, Slingluff CL. Surgery investigators funded through the National Institutes of Health: A rebirth. Surgery 2017; 161:1482-1488. [PMID: 28161005 DOI: 10.1016/j.surg.2016.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/22/2016] [Accepted: 12/02/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Funding toward surgical research through the National Institutes of Health has decreased relative to other medical specialties. This study was initiated to characterize features of academically successful surgeon-scientists and departments of surgery. We hypothesized that there may be decreases in young investigators obtaining independent National Institutes of Health awards and that successful academic departments of surgery may be depending increasingly on PhD faculty. METHODS The National Institutes of Health RePORTER database was queried for grants awarded to departments of surgery during fiscal years 2003 and 2013. Grant summaries were categorized by research methodology. Training of the principal investigator and academic position were determined through the RePORTER database and publicly available academic biographies. Institutions were ranked by number of grants funded. RESULTS Between 2003 and 2013, total surgery grants awarded decreased by 19%. The number of National Institutes of Health-funded, clinically active surgeons (MDs) decreased 11%, while funded PhDs increased 9%; however, clinically active junior faculty have comprised an increasing proportion of funded MDs (from 20-38%). Shifts in research topics include an increasing proportion of investigators engaged in outcomes research. Among institutions ranking in the top 20 for surgical research in both 2003 and 2013 (N = 15), the ratio of MDs to PhDs was 2:1 in both fiscal years. Among institutions falling out of the top 20, this ratio was less than 1:1. CONCLUSION There has been an expansion of outcomes-based surgical research. The most consistently successful institutions are those that actively cultivate MD researchers. Encouragingly, the number of young, independently funded surgeon-scientists in America appears to be increasing.
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Affiliation(s)
- Yinin Hu
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Brandy L Edwards
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Kevin Hu
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Kendall D Brooks
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Craig L Slingluff
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA.
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Stevenson MD, Smigielski EM, Naifeh MM, Abramson EL, Todd C, Li STT. Increasing Scholarly Activity Productivity During Residency: A Systematic Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:250-266. [PMID: 27049539 DOI: 10.1097/acm.0000000000001169] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Although resident participation in scholarly activity is mandated by the Accreditation Council for Graduate Medical Education, programmatic factors associated with success are not defined. This systematic review's objective was to determine which interventions are effective in increasing resident scholarly activity productivity (RSAP), as measured by participation in scholarly activity, presentations, or publications. METHOD The PubMed, MEDLINE, Cochrane Library of Systematic Reviews, PsycINFO, CINAHL, and ERIC databases were searched through October 2013. English-language articles evaluating interventions to increase RSAP in U.S. or Canadian residency programs were included, without date limits. Two independent reviewers selected articles for inclusion and extracted data. Discrepancies were resolved by consensus. RESULTS Of the 6,248 records screened, 80 studies underwent data abstraction. Twenty-six described outcomes without a comparison group, leaving 54 studies representing 13 medical and surgical specialties. Interventions included required scholarly activity participation, protected research time, research curricula, research directors, dedicated research days, and research tracks. Focusing on the 35 studies reporting statistical analysis, RSAP was associated with all interventions. There were some differences in intervention effectiveness between medical and surgical specialties. CONCLUSIONS Interventions, including protected time, research curricula, or specialized research tracks, generally result in increased participation in scholarly activity in residency programs, with mixed effects on resident presentations or publications. In many studies, interventions were bundled, suggesting that programs may need to provide increased structure and rigor through multiple pathways. The findings highlight the need for a clear definition of resident scholarly activity success aligned specifically to individual program and resident aims.
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Affiliation(s)
- Michelle D Stevenson
- M.D. Stevenson is associate professor, Department of Pediatrics, University of Louisville, Louisville, Kentucky. E.M. Smigielski was professor, Kornhauser Health Sciences Library, University of Louisville, Louisville, Kentucky, at the time of writing. M.M. Naifeh is clinical associate professor, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. E.L. Abramson is assistant professor, Departments of Pediatrics and Healthcare Policy & Research, Weill Cornell Medicine, New York, New York. C. Todd is associate professor, Department of Pediatrics, Texas Tech University, Lubbock, Texas. S.T. Li is associate professor, vice chair of education, and pediatric program director, Department of Pediatrics, University of California, Davis, Sacramento, California
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Shah PM, Edwards BL, Dietch ZC, Sawyer RG, Schroen AT. Relationship of a Second Professional Degree to Research Productivity of General Surgery Residents. JOURNAL OF SURGICAL EDUCATION 2017; 74:124-130. [PMID: 27651050 DOI: 10.1016/j.jsurg.2016.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/19/2016] [Accepted: 08/01/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Many general surgery residents interrupt clinical training for research pursuits or advanced degrees during dedicated research time (DRT). We hypothesize that time required to obtain a second degree during DRT decreases resident publication productivity. DESIGN, SETTING, AND PARTICIPANTS All consecutive categorical general surgery residents at the University of Virginia in Charlottesville, VA, graduating in 2007 to 2016 were evaluated. PubMed queries identified journal publications for residents during and after DRT, limited to 1 year postgraduation. DRT varied between 1 and 3 years and was standardized by dividing publication number by DRT plus remaining clinical years and 1 postgraduation year. Median publications were compared between residents by receipt of a second degree. RESULTS Thirty-six residents were eligible for analysis. Of these, 8 obtained a Master's in Clinical Research, 3 received Master of Public Health, and 1 completed a Doctorate of Philosophy. Publications ranged from 2 to 76 for degree residents and 1 to 36 for nondegree residents. For the 12 degree residents, median publication number per year was 3.8 (interquartile range: 2.3, 5.2) compared to 2.6 (interquartile range: 1.6, 3.5) in residents not pursuing a postdoctoral degree (p = 0.04). There was no significant difference in median number of first and second author publications by degree status. CONCLUSION More publications per year were seen among residents earning a second degree, with a statistically significant difference between residents obtaining postdoctoral degrees during DRT compared with their counterparts. Our study demonstrates that residents pursuing a second degree are not hindered in their publication productivity despite the time investment required by the degree program. Additional research is needed to determine whether formal research training through a second degree corresponds to sustained scholarly productivity beyond residency.
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Affiliation(s)
- Puja M Shah
- Department of Surgery, University of Virginia, Charlottesville, Virginia
| | - Brandy L Edwards
- Department of Surgery, University of Virginia, Charlottesville, Virginia
| | - Zachary C Dietch
- Department of Surgery, University of Virginia, Charlottesville, Virginia
| | - Robert G Sawyer
- Department of Surgery, University of Virginia, Charlottesville, Virginia
| | - Anneke T Schroen
- Department of Surgery, University of Virginia, Charlottesville, Virginia.
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Wells CI, Robertson JP, O'Grady G, Bissett IP. Trends in publication of general surgical research in New Zealand, 1996-2015. ANZ J Surg 2016; 87:76-79. [PMID: 27804200 DOI: 10.1111/ans.13821] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 09/21/2016] [Accepted: 09/22/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Recent analyses of the surgical literature have suggested a general trend towards increasing numbers of published articles and an improved quality of evidence produced. The aim of this bibliometric analysis was to identify trends in the publication of general surgical research in New Zealand from 1996 to 2015. METHODS Ovid MEDLINE was searched for general surgical publications by New Zealand authors. Two investigators screened results, and a range of data were collected for included articles. Descriptive statistics were used to summarize data and identify significant trends. RESULTS A total of 601 articles were identified, with a progressive increase in the number of publications from 1996 to 2015. Randomized trials and systematic reviews accounted for 33 and 97 publications, respectively. The median number of authors per paper rose from 3.0 to 5.0 (P < 0.001). There was an exponential increase in the publication of randomized trials (P = 0.001) and systematic reviews (P < 0.001), while publication of basic science articles remained relatively steady (P = 0.22). The median impact factor for published articles increased from 1.5 to 2.6, which was equivalent to organic growth of the journal impact factors over the 20-year period. CONCLUSION The quality and quantity of surgical research in New Zealand has substantially increased over the past two decades. These results reflect the successful growth of a culture of academic surgery and the ongoing support of partner organizations.
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Affiliation(s)
- Cameron I Wells
- Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jason P Robertson
- Department of Surgery, Palmerston North Hospital, Mid-Central District Health Board, Palmerston North, New Zealand
| | - Gregory O'Grady
- Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Ian P Bissett
- Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,Department of Surgery, Auckland District Health Board, Auckland, New Zealand
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Thompson PW, Roser SM. Do the Science, Own the Field. Are We Doing the Science? J Oral Maxillofac Surg 2015; 73:S153-4. [PMID: 26608146 DOI: 10.1016/j.joms.2015.04.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/23/2015] [Indexed: 10/22/2022]
Abstract
For oral and maxillofacial surgery to continue being a premier specialty in the management of patients with craniomaxillofacial conditions, contributions to the better treatment of these patients must be continuously offered. Without performing the science, these offerings will not come or will not be valid. Environmental and funding challenges to performing the science have increased in the past 2 decades. The incorporation of protected research time and a research sabbatical for residents within their training program might be effective ways to meet these challenges.
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Affiliation(s)
- Peter W Thompson
- Fellow in Plastic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Steven M Roser
- Delos Hill Professor and Chief, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
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D'Angelo ALD, Ray RD, Jenewein CG, Jones GF, Pugh CM. Residents' perception of skill decay during dedicated research time. J Surg Res 2015. [PMID: 26197949 DOI: 10.1016/j.jss.2015.06.040] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Surgery residents may take years away from clinical responsibilities for dedicated research time. As part of a longitudinal project, the study aim was to investigate residents' perceptions of clinical skill reduction during dedicated research time. Our hypothesis was that residents would perceive a greater potential reduction in skill during research time for procedures they were less confident in performing. MATERIALS AND METHODS Surgical residents engaged in dedicated research training at multiple training programs participated in four simulated procedures: urinary catheterization, subclavian central line, bowel anastomosis, and laparoscopic ventral hernia (LVH) repair. Using preprocedure and postprocedure surveys, participants rated procedures for confidence and difficulty. Residents also indicated the perceived level of skills reduction for the four procedures as a result of time in the laboratory. RESULTS Thirty-eight residents (55% female) completed the four clinical simulators. Participants had between 0-36 mo in a laboratory (M = 9.29 mo, standard deviation = 9.38). Preprocedure surveys noted lower confidence and higher perceived difficulty for performing the LVH repair followed by bowel anastomosis, central line insertion, and urinary catheterization (P < 0.05). Residents perceived the greatest reduction in bowel anastomosis and LVH repair skills compared with urinary catheterization and subclavian central line insertion (P < 0.001). Postprocedure surveys showed significant effects of the simulation scenarios on resident perception for urinary catheterization (P < 0.05) and LVH repair (P < 0.05). CONCLUSIONS Residents in this study expected greater skills decay for the procedures they had lower confidence performing and greater perceived difficulty. In addition, carefully adapted simulation scenarios had a significant effect on resident perception and may provide a mechanism for maintaining skills and keeping confidence grounded in experience.
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Affiliation(s)
- Anne-Lise D D'Angelo
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin. ad'
| | - Rebecca D Ray
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Caitlin G Jenewein
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Grace F Jones
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Carla M Pugh
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
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Hu Y, Edwards BL, Brooks KD, Newhook TE, Slingluff CL. Recent trends in National Institutes of Health funding for surgery: 2003 to 2013. Am J Surg 2015; 209:1083-9. [PMID: 25929766 DOI: 10.1016/j.amjsurg.2015.01.015] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 11/19/2014] [Accepted: 01/11/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study is to compare the compositions of federally funded surgical research between 2003 and 2013, and to assess differences in funding trends between surgery and other medical specialties. DATA SOURCES The National Institutes of Health (NIH) Research Portfolio Online Reporting Tool database was queried for grants within core surgical disciplines during 2003 and 2013. Funding was categorized by award type, methodology, and discipline. Application success rates for surgery and 5 nonsurgical departments were trended over time. CONCLUSIONS Inflation-adjusted NIH funding for surgical research decreased 19% from $270 M in 2003 to $219 M in 2013, with a shift from R-awards to U-awards. Proportional funding to outcomes research almost tripled, while translational research diminished. Nonsurgical departments have increased NIH application volume over the last 10 years; however, surgery's application volume has been stagnant. To preserve surgery's role in innovative research, new efforts are needed to incentivize an increase in application volume.
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Affiliation(s)
- Yinin Hu
- Department of Surgery, University of Virginia School of Medicine, P.O. Box 800709, Charlottesville, VA 22908-0709, USA
| | - Brandy L Edwards
- Department of Surgery, University of Virginia School of Medicine, P.O. Box 800709, Charlottesville, VA 22908-0709, USA
| | - Kendall D Brooks
- Department of Surgery, University of Virginia School of Medicine, P.O. Box 800709, Charlottesville, VA 22908-0709, USA
| | - Timothy E Newhook
- Department of Surgery, University of Virginia School of Medicine, P.O. Box 800709, Charlottesville, VA 22908-0709, USA
| | - Craig L Slingluff
- Department of Surgery, University of Virginia School of Medicine, P.O. Box 800709, Charlottesville, VA 22908-0709, USA.
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Upchurch GR, Freischlag JA, Novicoff W, Early K, Turner PL, Zinner MJ. Survey of the American College of Surgeons scholarship recipients: a story of generating academic leaders. J Am Coll Surg 2015; 220:1122-1127.e3. [PMID: 25998084 DOI: 10.1016/j.jamcollsurg.2015.02.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 02/24/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The objective of this survey was to provide a review of the American College of Surgeons (ACS) scholarship activity. STUDY DESIGN The domestic ACS scholarship recipient survey was electronically transmitted twice to awardees from 1987 to 2007 (n=253). Themes of the survey included type of practice, activities during scholarship period, success of peer review funding, and the role of mentors. All survey responses were evaluated using SPSS version 20. RESULTS There were 123 total responses, with 108 separate respondents (94, 1 award; 13, 2 awards; 1, 3 awards). The group averaged 11.8 years in clinical practice, with the majority (90.2%) having an academic appointment. Seventy-seven percent of respondents were on a tenure track, and almost three-quarters (72.4%) of the respondents hold a major leadership position. In terms of research, 67.5% of respondents have received extramural funding; 10.6% have received patents. The average number of publications related to their funded research is 19.2 (range 0 to 180). Most respondents perform peer review of research (73.2%), learned about the peer review process during their funding period (82.1%), and mentor medical students (88.6%). The average number of students currently mentored is 6.4; the average total trainees mentored is 13. Despite the significant research responsibilities of respondents, they still spend more time performing clinical care (49.2%) than research (30.4%). CONCLUSIONS The ACS scholarship has a significant impact on the recipient's academic career, even in the setting of increasing clinical burdens. This program also appears to tangentially identify surgeons who become leaders in academic surgery.
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Affiliation(s)
| | | | - Wendy Novicoff
- Department of Orthopaedic Surgery and Public Health Sciences, University of Virginia, Charlottesville, VA
| | - Kate Early
- Division of Surgical Education, American College of Surgeon, Chicago, IL
| | - Patricia L Turner
- Division of Surgical Education, American College of Surgeon, Chicago, IL
| | - Michael J Zinner
- Department of Surgery, Brigham and Women's Hospital, Harvard University, Boston, MA
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Smith JJ, Patel RK, Chen X, Tarpley MJ, Terhune KP. Does intentional support of degree programs in general surgery residency affect research productivity or pursuit of academic surgery? JOURNAL OF SURGICAL EDUCATION 2014; 71:486-491. [PMID: 24794064 DOI: 10.1016/j.jsurg.2014.01.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 01/12/2014] [Accepted: 01/27/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Many residents supplement general surgery training with years of dedicated research, and an increasing number at our institution pursue additional degrees. We sought to determine whether it was worth the financial cost for residency programs to support degrees. DESIGN We reviewed graduating chief residents (n = 69) in general surgery at Vanderbilt University from 2001 to 2010 and collected the data including research time and additional degrees obtained. We then compared this information with the following parameters: (1) total papers, (2) first-author papers, (3) Journal Citation Reports impact factors of journals in which papers were published, and (4) first job after residency or fellowship training. SETTING The general surgery resident training program at Vanderbilt University is an academic program, approved to finish training 7 chief residents yearly during the time period studied. PARTICIPANTS Chief residents in general surgery at Vanderbilt who finished their training 2001 through 2010. RESULTS We found that completion of a degree during residency was significantly associated with more total and first-author publications as compared with those by residents with only dedicated research time (p = 0.001 and p = 0.017). Residents completing a degree also produced publications of a higher caliber and level of authorship as determined by an adjusted resident impact factor score as compared with those by residents with laboratory research time only (p = 0.005). Degree completion also was significantly correlated with a first job in academia if compared to those with dedicated research time only (p = 0.046). CONCLUSIONS Our data support the utility of degree completion when economically feasible and use of dedicated research time as an effective way to significantly increase research productivity and retain graduates in academic surgery. Aggregating data from other academic surgery programs would allow us to further determine association of funding of additional degrees as a means to encourage academic productivity and retention.
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Affiliation(s)
- Jesse Joshua Smith
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ravi K Patel
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Xi Chen
- Division of Cancer Biostatistics, Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Margaret J Tarpley
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kyla P Terhune
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
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Hsieh H, Paquette F, Fraser SA, Feldman LS, Meterissian S, Fried GM, Bergman S. Formal research training during surgical residency: scaffolding for academic success. Am J Surg 2014; 207:141-5. [DOI: 10.1016/j.amjsurg.2013.04.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 04/17/2013] [Accepted: 04/29/2013] [Indexed: 11/16/2022]
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Yarger JB, James TA, Ashikaga T, Hayanga AJ, Takyi V, Lum Y, Kaiser H, Mammen J. Characteristics in response rates for surveys administered to surgery residents. Surgery 2013; 154:38-45. [PMID: 23809484 DOI: 10.1016/j.surg.2013.04.060] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 04/26/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Surveys are important research tools that permit the accumulation of information from large samples that would otherwise be impractical to collect. Resident surveys have been used frequently to monitor the quality of postgraduate training. Low response rates threaten the utility of this research tool. The purpose of this study was to determine the standard response rate of surveys administered to surgery residents and identify characteristics associated with achieving greater response rates. METHODS A search of peer-reviewed literature published between September 2003 and June 2011 was performed with the use of PubMed with Medical Subject Headings: "internship and residency," "surgery," "data collection," and "questionnaires." For inclusion, articles must have described a survey given to active surgery residents within the United States. Surveys were evaluated based on the following criteria: population size, response rate, incentive use, follow-up use, survey format (online vs paper), and institution versus national. RESULTS Of 433 initial results, 47 met inclusion criteria with a mean response rate of 65.3%. Surveys administered in paper format had a greater response rate compared with those given electronically (mean 78.6% vs 36.4%, respectively, P < .001). Greatest mean response rates were seen for institutional surveys compared with those given nationally (83.1% vs 42% respectively, P < .001). CONCLUSION Our review demonstrated that paper surveys administered at the institutional level and during assemblies integrated into residents' schedules demonstrated enhanced response rates. The validity and generalizability of data collected through such surveys will improve as the aspects which dictate response rate are better understood and implemented.
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Affiliation(s)
- John B Yarger
- University of Vermont College of Medicine, Burlington, VT, USA.
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Hassan B, Bernstam E, Hines OJ, Simeone DM, Weber SM, Geller DA, Evers BM, Meric-Bernstam F. Career track of Society of University Surgeons Resident Research Award recipients. J Surg Res 2013; 185:92-6. [PMID: 23751805 DOI: 10.1016/j.jss.2013.05.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 04/24/2013] [Accepted: 05/03/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Society of University Surgeons (SUS) has an ongoing competitive funding program to support research training for residents. We sought to determine the career track of award recipients. METHODS We included in the study SUS resident awardees who completed awards from 1989-2007. Characteristics of awardees and their academic productivity were extracted from curriculum vitae provided by awardees (n = 24), or from online sources (n = 7). RESULTS Awardees spent an average of 2.7 y (range, 1-4 y) of dedicated research time during residency. Awardees averaged 9.8 publications (range, 1-32), with 5.4 as first author (range, 1-17), with their mentor within 3 y of award completion, with an average maximum impact factor of 5.7. A total of 25 residents (81%) pursued fellowships. At an average follow-up of 11.4 y (range, 4-22 y) from the end of the award and 7.2 y (range, 0-18 y) from end of clinical training, awardees had a Hirsch index of 14.5 (range, 2-48). At the time of the study, 26 awardees (84%) were in academic surgery. Of the 23 awardees who had completed surgical training ≥ 3 y earlier, 11 (48%) received independent research funding, seven of whom (30%) received R01 or equivalent funding. CONCLUSIONS The SUS resident research awardees had a productive research experience. Although our retrospective study cannot determine causation, the SUS award mechanism delivers on its promise of supporting junior surgeon-scientists who pursue academic careers and establish independent research programs. Further studies are needed to determine how rates of subsequent independent research funding can be improved.
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Affiliation(s)
- Burhan Hassan
- Department of Surgical Oncology, Unit 1484, University of Texas MD Anderson Cancer Center, Houston, Texas
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Talay-Değirmenci I, Holmes CJ, Kuo PC, Jennings OB. An analytic decision support tool for resident allocation. JOURNAL OF SURGICAL EDUCATION 2013; 70:31-35. [PMID: 23337667 DOI: 10.1016/j.jsurg.2012.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 06/01/2012] [Accepted: 07/06/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Moving residents through an academic residency program is complicated by a number of factors. Across all residency programs the percentage of residents that leave for any reason is between 3.4% and 3.8%.(1) There are a number of residents that participate in research. To avoid discrepancies in the number of residents at the all levels, programs must either limit the number of residents that go into the lab, the number that return to clinical duties, or the number of interns to hire. Traditionally this process consists of random selection and trial and error with names on magnetic strips moved around a board. With the matrix that we have developed this process is optimized and aided by a Microsoft Excel macro (Microsoft Corp, Redmond, Washington). METHODS We suggest that a residency program would have the same number of residents at each residency stage of clinical practice, as well as a steady number of residents at each research stage. The program consists of 2 phases, in the first phase, an Excel sheet called the "Brain Sheet," there are simple formulas that we have prepared to determine the number of interns to recruit, residents in the research phase, and residents that advance to the next stage of training. The second phase of the program, the macro, then takes the list of current resident names along with the residency level they are in, and according to the formulas allocates them to the relevant stages for future years, creating a resident matrix. RESULTS Our macro for resident allocation would maximize the time of residency program administrators by simplifying the movement of residents through the program. It would also provide a tool for planning the number of new interns to recruit and program expansion. CONCLUSIONS The application of our macro illustrates that analytical techniques can be used to minimize the time spent and avoid the trial and error while planning resident movement in a program.
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Affiliation(s)
- Işılay Talay-Değirmenci
- Department of Business Administration, College of Business, Antalya International University, Antalya, Turkey
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Mohan HM, O'Riordan JM, Collins D, O'Connor DB, Traynor O, Winter DC. Bench and bedside? Surgeons' views on the role of research in surgical training. Ir J Med Sci 2012. [PMID: 23179667 DOI: 10.1007/s11845-012-0870-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIMS Internationally, surgical training is facing the challenge of balancing research and clinical experience in the context of reduced working hours. This study aimed to investigate trainees and trainers' views on surgeons participating in full-time research during surgical training. METHODS An anonymous voluntary survey was conducted of surgical trainers and trainees in two training systems. To examine surgeons' views across two different training schemes, surgeons were surveyed in Ireland (Royal College of Surgeons in Ireland) and in a Canadian centre (University of Toronto) between January 2009 and September 2010 (n = 397 respondents). RESULTS The majority of respondents felt that time spent in research by trainees was important for surgery as a specialty, while 65 % felt that research was important for surgical trainees (trainers 79 %, trainees 60 %, p = 0.001). A higher proportion of Canadian surgeons reported that they enjoyed their time spent in research, compared to Irish surgeons (84 vs. 66 %, p = 0.05). Financial worries and loss of clinical time were common demotivating factors. Full-time research was more popular than part-time options to obtain a post-graduate degree. CONCLUSIONS Most agree that research remains an important component of surgical training. However, there are significant differences in opinion among surgeons in different countries on the precise role and structure of research in surgical training.
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Affiliation(s)
- H M Mohan
- Department of Surgery, iCORE (Institute for Clinical Outcomes in Research and Education), St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
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Stain SC, Cogbill TH, Ellison EC, Britt L, Ricotta JJ, Calhoun JH, Baumgartner WA. Surgical Training Models: A New Vision. Curr Probl Surg 2012; 49:565-623. [DOI: 10.1067/j.cpsurg.2012.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Stutchfield BM, Harrison EM, Wigmore SJ, Parks RW, Garden OJ. Outcomes following a dedicated period of research during surgical training. Scott Med J 2012; 56:206-9. [PMID: 22089041 DOI: 10.1258/smj.2011.011159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
With recent 'working-time'-related changes to surgical training structure, the value of dedicated research during surgical training has been questioned. Online survey examining career and academic outcomes following a period of surgically related dedicated research at a Scottish University between 1972 and 2007. Of 58 individuals identified, contact details were available for 49 and 43 (88%) responded. Ninety-five percent (n = 41) of respondents continue to pursue a career in surgery and 41% (n = 17) are currently in academic positions. Ninety-one percent (n = 39) had published one or more first-author peer-reviewed articles directly related to their research, with 53% (n = 23) publishing three or more. Respondents with a clinical component to their research published significantly more papers than those with purely laboratory-based research (P = 0.04). Eighty-one percent (n = 35) thought that research was necessary for career progression, but only 42% (n = 18) felt research should be integral to training. In conclusion, the majority of surgical trainees completing a dedicated research period, published papers and continued to pursue a surgical career with a research interest. A period of dedicated research was thought necessary for career progression, but few thought dedicated research should be integral to surgical training.
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Affiliation(s)
- B M Stutchfield
- Clinical and Surgical Sciences (Surgery), University of Edinburgh, Edinburgh, Scotland, UK.
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Abstract
Increasing concern has been expressed about the significant shortage of new trainees in surgery. As research in the context of surgical education and training is an essential element of attraction for the field of surgery, there is an urgent priority to implement clear room for research in the concepts of education and training. In this article the relevance of both the thesis accompanying the study and research training during surgical residency for the clinical self-image, personal satisfaction and academic development of young surgeons will be presented.
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