Your SlideShare is downloading. ×
0
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Evolution in Fellowship Selection during General Surgery ...
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Evolution in Fellowship Selection during General Surgery ...

989

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
989
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
3
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Evolution in Fellowship Selection during General Surgery Residencies Laura R. Vick, MD Karen R. Borman, MD University of Mississippi Medical Center, Jackson, MS
  • 2. <ul><li>Increasing numbers of graduating residents are pursuing fellowships </li></ul><ul><li>PGY-5 choices are heterogeneous </li></ul><ul><ul><li>Individual variables </li></ul></ul><ul><ul><li>(e.g. - gender) </li></ul></ul><ul><ul><li>Residency characteristics </li></ul></ul><ul><ul><li>(e.g. - program location) </li></ul></ul><ul><ul><li>Over time </li></ul></ul>Background
  • 3. <ul><li>PGY-1 fellowship choices unreported </li></ul><ul><li>For this study </li></ul><ul><ul><li>PGY-1 future fellowship choices from ‘93 - ‘07 </li></ul></ul><ul><ul><li>Changes in preferences </li></ul></ul><ul><ul><ul><li>over time </li></ul></ul></ul><ul><ul><ul><li>as residents progress during training </li></ul></ul></ul><ul><ul><li>Fellowship choices as related to demographic variables </li></ul></ul><ul><ul><ul><li>Gender </li></ul></ul></ul><ul><ul><ul><li>Program type, size and location </li></ul></ul></ul>Background
  • 4. <ul><li>ABSITE examination data – last 15 years </li></ul>Methods = “Any Fellowship” Other Specialty SCC split from Trauma/Burn Vascular Surgery Endoscopy Transplantation Endocrine Surgery Thoracic Surgery Bariatric Surgery Plastic Surgery Additional choices for 2007 Pediatric Surgery Oncology Breast Surgery SCC/Trauma/Burn Hepatobiliary Surgery Colon & Rectal Advanced GI Surgery Undecided Minimally Invasive Surgery No Fellowship Additional choices for 2006 Choices for 1993-2005
  • 5. Methods - Datasets PGY-5 1993 - 2005 PGY-1 1993 - 2003 All residents 1993 - 2007 Dataset 1 Remove Designated Preliminary / Hand Dataset 3 Paired PGY-1 and PGY-5 responses Residents applying for ABS Qualifying Exam by July 2007 Dataset 2
  • 6. <ul><li>Dataset 1: > 80,000 responses </li></ul><ul><ul><li>> 20,000 PGY-1 responses </li></ul></ul>Results Undecided Responses 1993, 2000, 2007 all PGY levels 2007 2000 1993 PGY-1 responses 38% 42% 46% Any Fellowship 7% 11% 8% No Fellowship 55% 46% 46% Undecided PGY-1 PGY-2 PGY-3 PGY-4 PGY-5
  • 7. <ul><li>Any Fellowship for PGY-1 </li></ul>Results 1% 2% 2% Transplant 2% 2% 2% CRS 8% 5% 3% Other 4% 4% 4% Oncology 3% 3% 4% Pediatric 5% 4% 4% SCC/Trauma/ Burn 3% 3% 5% Vascular 9% 11% 10% Plastic 3% 7% 10% Thoracic 2007 2000 1993 2007 2000 1993 PGY-1 responses 38% 42% 46% Any Fellowship 7% 11% 8% No Fellowship 55% 46% 46% Undecided
  • 8. <ul><li>Any Fellowship for all PGY years </li></ul>Results PGY-1 PGY-2 PGY-3 PGY-4 PGY-5
  • 9. <ul><li>No Fellowship for all PGY years </li></ul>Results PGY-1 PGY-2/3 PGY-4 PGY-5 2007 2000 1993 PGY-1 responses 38% 42% 46% Any Fellowship 7% 11% 8% No Fellowship 55% 46% 46% Undecided
  • 10. Results <ul><li>Dataset 2: > 19,000 responses </li></ul><ul><ul><li>9,000 PGY-1 responses </li></ul></ul>Responses by Gender for all years 1993 - 2003 Female % Male %
  • 11. Results 2% 1% 1% 4% 4% 2% Other Specialty 4% 5% 7% 2% 3% 1% Vascular Surgery 2% 4% 2% 1% 1% 2% Transplantation 11% 10% 16% 4% 3% 2% Thoracic Surgery 10% 3% 6% 15% 3% 8% Plastic Surgery 3% 3% 5% 4% 8% 9% Pediatric Surgery 4% 5% 4% 6% 12% 8% Oncology 4% 6% 6% 2% 5% 3% SCC/Trauma/Burn 5% 2% 3% 2% 1% 4% Colon & Rectal 51% 56% 46% 57% 57% 55% Undecided 5% 5% 5% 5% 4% 7% No Fellowship 2003 1998 1993 2003 1998 1993 Male Female
  • 12. Results <ul><li>Program Type </li></ul>2% 2% 1% 3% 2% 1% Other Specialty 2% 4% 7% 4% 4% 5% Vascular Surgery 1% 3% 2% 2% 3% 2% Transplantation 9% 6% 10% 10% 10% 16% Thoracic Surgery 11% 3% 8% 10% 3% 5% Plastic Surgery 1% 2% 3% 5% 5% 7% Pediatric Surgery 2% 6% 3% 6% 7% 6% Oncology 3% 6% 8% 4% 5% 2% SCC/Trauma/Burn 4% 1% 4% 4% 2% 2% Colon & Rectal 60% 61% 47% 47% 54% 49% Undecided 5% 6% 8% 5% 4% 4% No Fellowship 2003 1998 1993 2003 1998 1993 Independent University
  • 13. Results <ul><li>Program Size </li></ul>3% 2% 1% 5% 13% 0% 3% 3% 3% 59% 7% 2003 3% 4% 1% 8% 4% 2% 4% 8% 1% 58% 10% 1998 1% 6% 2% 12% 10% 3% 1% 8% 5% 42% 10% 1993 Small 2% 2% 3% 3% 1% 1% Other Specialty 2% 3% 2% 4% 5% 6% Vascular Surgery 1% 4% 1% 2% 3% 2% Transplantation 9% 6% 5% 12% 10% 12% Thoracic Surgery 13% 3% 13% 8% 3% 6% Plastic Surgery 3% 6% 0% 5% 4% 6% Pediatric Surgery 8% 7% 3% 3% 7% 6% Oncology 2% 3% 3% 4% 6% 5% SCC/Trauma/Burn 4% 2% 3% 4% 2% 2% Colon & Rectal 52% 46% 59% 49% 57% 50% Undecided 3% 20% 7% 5% 3% 5% No Fellowship 2003 1998 1993 2003 1998 1993 Large Medium
  • 14. Results <ul><li>Program Location over all years </li></ul>
  • 15. Results <ul><li>Dataset 3: 12,259 paired responses </li></ul><ul><ul><li>6,111 PGY-1 chose Undecided (50%) </li></ul></ul><ul><ul><li>Of the Undecided </li></ul></ul><ul><ul><ul><li>No Fellowship (24%) </li></ul></ul></ul><ul><ul><ul><li>Vascular Surgery (12%) </li></ul></ul></ul><ul><ul><ul><li>Other Fellowship (12%) </li></ul></ul></ul><ul><li>Only 22% of all PGY-1 residents </li></ul><ul><li>accurately identified their final </li></ul><ul><li>post-residency plans </li></ul>
  • 16. Conclusions <ul><li>Majority of incoming residents are Undecided </li></ul><ul><li>Fellowship choices evolve as PGY level advances </li></ul><ul><li>Evolution occurs at variable rates </li></ul><ul><li>Uncertainty for PGY-1 residents is desirable, reflecting open-mindedness </li></ul><ul><li>Junior residents should experience the full spectrum of potential fellowship areas </li></ul>
  • 17. Discussion <ul><li>The number of residents choosing fellowships are increasing </li></ul><ul><li>Fellowships chosen have changed over time </li></ul><ul><li>PGY-1 residents unsure whether to pursue fellowship </li></ul><ul><li>Alternative educational pathways are being evaluated and implemented </li></ul>
  • 18. Discussion <ul><li>Educational models featuring early specialty tracking continue to proliferate </li></ul><ul><li>These models should include exposure to all areas of specialization </li></ul><ul><li>Examination of PGY-1 fellowship training choices could contribute to the ongoing process of residency redesign </li></ul><ul><li>Further studies underway to determine the final plans of the 78% percent of residents who change their mind </li></ul>
  • 19. University of Mississippi Medical Center

×