Successfully reported this slideshow.
Evolution in Fellowship Selection during General Surgery Residencies Laura R. Vick, MD Karen R. Borman, MD University of M...
<ul><li>Increasing numbers of graduating residents are pursuing fellowships </li></ul><ul><li>PGY-5 choices are heterogene...
<ul><li>PGY-1 fellowship choices unreported </li></ul><ul><li>For this study </li></ul><ul><ul><li>PGY-1 future fellowship...
<ul><li>ABSITE examination data – last 15 years </li></ul>Methods =  “Any Fellowship” Other Specialty SCC split from Traum...
Methods - Datasets PGY-5 1993 - 2005 PGY-1 1993 - 2003 All residents 1993 - 2007 Dataset 1 Remove Designated Preliminary /...
<ul><li>Dataset 1: > 80,000 responses </li></ul><ul><ul><li>> 20,000 PGY-1 responses </li></ul></ul>Results Undecided Resp...
<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%...
<ul><li>Any Fellowship for all PGY years </li></ul>Results PGY-1 PGY-2 PGY-3 PGY-4 PGY-5
<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%...
Results <ul><li>Dataset 2: > 19,000 responses </li></ul><ul><ul><li>9,000 PGY-1 responses </li></ul></ul>Responses by Gend...
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%...
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%...
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% ...
Results <ul><li>Program Location over all years </li></ul>
Results <ul><li>Dataset 3: 12,259 paired responses </li></ul><ul><ul><li>6,111 PGY-1 chose Undecided (50%) </li></ul></ul>...
Conclusions <ul><li>Majority of incoming residents are Undecided </li></ul><ul><li>Fellowship choices evolve as PGY level ...
Discussion <ul><li>The number of residents choosing fellowships are increasing </li></ul><ul><li>Fellowships chosen have c...
Discussion <ul><li>Educational models featuring early specialty tracking continue to proliferate </li></ul><ul><li>These m...
University of Mississippi  Medical Center
Upcoming SlideShare
Loading in …5
×

Evolution in Fellowship Selection during General Surgery ...

1,169 views

Published on

  • Be the first to comment

  • Be the first to like this

Evolution in Fellowship Selection during General Surgery ...

  1. 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. 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. 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. 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. 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. 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. 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. 8. <ul><li>Any Fellowship for all PGY years </li></ul>Results PGY-1 PGY-2 PGY-3 PGY-4 PGY-5
  9. 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. 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. 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. 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. 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. 14. Results <ul><li>Program Location over all years </li></ul>
  15. 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. 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. 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. 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. 19. University of Mississippi Medical Center

×