What do General Surgery Residents Operate During the Residency Program? An Analysis of the Applicability of the Specialty Program in General and Digestive Surgery

Abstract

Residents in our country have achieved a homogenous surgical training by following a structured residency program. This is due to the existence of specific training programs for each specialty. The current program, approved in 2007, has a detailed list of procedures that a surgeon should have performed in order to complete training. The aim of this study is to analyze the applicability of the program with regard to the number of procedures performed during the residency period. Material and methodsA data collection form was designed that included the list of procedures from the program of the specialty; it was sent in April 2014 to all hospitals with accredited residency programs. In September 2014 the forms were analyzed, and a general descriptive study was performed; a subanalysis according to the resident's sex and Autonomous region was also performed. The number of procedures performed according to the number of residents in the different centers was also analyzed. ResultsThe survey was sent to 117 hospitals with accredited programs, which included 190 resident places. A total of 91 hospitals responded (53%). The training offered adapts in general to the specialty program. The total number of procedures performed in the different sub-areas, in laparoscopic and emergency surgery is correct or above the number recommended by the program, with the exception of esophageal-gastric and hepatobiliary surgery. The sub-analysis according to Autonomous region did not show any significant differences in the total number of procedures, however, there were significant differences in endocrine surgery (P=.001) and breast surgery (P=.042). A total of 55% of residents are female, with no significant differences in distribution in Autonomous regions. However, female surgeons operate more than their male counterparts during the residency period (512±226 vs 625±244; P<.01). The number of residents in the hospital correlates with the number of procedures performed; the residents with more procedures trained in hospitals where there were less residents (669±237 vs 527±209; P=.004). ConclusionThe surgical activity performed by Spanish surgeons is adequate to the specialty program, except in hepatobiliary and esophageal-gastric surgery. The distribution is homogeneous in the different autonomous regions, although there are differences that depend on the number and sex of the residents in each hospital. This information is essential to evaluate the quality of the specialty program and to design new training programs.