THE CHANGING SIZE OF ANESTHESIOLOGY TRAINING PROGRAMS

Abstract

S182 Introduction: The number of residents entering anesthesiology training programs has been declining. While the NRMP data has been widely reported, less information has been available about the actual reductions in program size. As part of a survey of resident evaluation practices, data was collected about the size of anesthesiology training programs. Methods: A survey was sent to the program directors of all ACGME approved training programs in anesthesiology. Data about program size was requested. Results: Surveys were sent to 144 training programs; 110 (76%) were completed and returned, for 108 (75%) the questions about the number of residents in training were completed. The average number of residents per class was: CA-1: 7.6 (range 0-23); CA-2: 9.2 (range 1-30); CA-3: 11.7 (range 2-35). Reporting on CA-1 residents, 20 programs had less than 3 residents (6 with zero); 9 had 3 residents; 10 had 4 residents. There were 6 programs in which the total number of residents (CA-1 to CA-3) was fewer than 9; 3 programs had 9 total residents; 8 had 10-12 total residents. The size of the CA-1 class compared to the CA-3 class (as a percentage of CA-3 size) is listed in Table 1 below. The average number of attendings reported was 43. The average resident-faculty ratio was 0.76 (range 0.063-4) with a ratio of <or=to 1 in 89 programs (82%).Table 1Discussion: As expected from the NRMP results, the number of residents entering training in anesthesiology has declined. Approximately sixty percent of programs reported that the size of their CA-1 class had decreased by 25 percent or more compared with their CA-3 class. The decline was generally greater in university programs compared to university affiliated or nonaffiliated programs. This challenges the idea that university programs are more desirable and therefore less vulnerable in the current market. Six programs were below the ACGME minimum requirement of 9 total residents and are, accordingly, in jeopardy of losing their accreditation. Extrapolating from the CA-1 size reported, 29 programs may be in a similar position in two years time if this trend continues. The resident-faculty ratio of less than or equal to one reported by more than 80% of programs suggests opportunities for improved educational experiences with close faculty resident interaction. Also, the reduction in program size provides the opportunity for service obligations to be separated from the educational organization of the program, as alternative arrangements are made to cover the service obligations. This may serve to strengthen the educational program by permitting resident assignments to be made on the basis of their educational value alone. This study was supported by the Society for Education in Anesthesia.