Training Surgeons in the Current US Healthcare System: A Review of Recent Changes in Resident Education

Abstract

This review highlights research focusing on the quality of surgical education within the current constraints of healthcare delivery in the United States. The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial has provided the first evidence from a randomized controlled trial regarding duty hour regulations. Results of the FIRST trial were instrumental in the 2017 ACGME Common Core Requirement changes that allow for more flexibility in clinical hours to encourage professionalism and accommodate both patient care and educational opportunities. Research focusing on resident autonomy has highlighted multiple factors necessary to ensure appropriate graduated levels of responsibility during training. Lastly, competency-based education provides a structured format to ensure minimum standards of performance in all graduates. More flexible hours, increasing autonomy, and competency-based evaluations may help improve confidence and competence of surgery residency graduates.