General Surgery Applicants Research Articles

Geographical Distribution and Trends Analysis of Osteopathic General Surgery Residents.

In recent years, the number of Doctor of Osteopathic Medicine (DO) residents entering general surgery has increased. As DOs continue to solidify their role within the surgical domain, understanding their distribution, preferences, and the dynamics of their integration into residency programs becomes crucial for general surgery applicants. Publicly available data were gathered for each DO general surgery resident from residency programs across the nation, including details such as post-graduate year, degrees held, and residency program location. A comprehensive cross-sectional analysis was conducted to determine the geographical distribution and match trends of DO residents in these residency programs. Analysis revealed a significant rise in the number of DOs entering general surgery residencies, from 153 DO trainees beginning their residency training in 2019 to 274 DO trainees beginning their residency training in 2024. This upward trend indicates a growing presence of DOs in surgical practice. Examination of the geographical locations of programs for which DO applicants have matched showed variations nationwide. This analysis allows for a deeper understanding of the evolving match trends for DOs in surgery. It highlights the importance of addressing disparities in access to surgical training opportunities for osteopathic physicians nationwide.

The cost of virtual interviews; more than just the money

PurposeThe COVID-19 pandemic resulted in travel restrictions to limit virus transmission, altering the residency interview process across the country. While the transition to virtual interviews has the potential benefit of convenience and cost savings, concerns remain about the impact on applicants’ ability to distinguish programs. We sought to understand individual applicant motivations when presented with the opportunity to interview in-person or virtually and the associated costs.MethodsAn anonymous, voluntary, mixed-methods survey was distributed to all US allopathic medical school general surgery applicants who applied to our program in the 2023 cycle. The primary outcome was identifying factors that impacted the decision to interview either in-person or virtually. Secondary outcomes included costs associated with the entire interview process, including travel for away rotations, in-person interviews, and program second looks.Results155 (21.3%) applicants completed the survey. The average number of interviews completed was 14.2 ± 6.25. Females completed more interviews than males (14.9, 12.6, p = 0.047). Respondents accepted a mean of 89% of virtual interviews offered. 73% of applicants selected to complete at least one interview in-person. Top reasons for electing in-person interviews were to gain a stronger impression of the program (64%), make a greater impression of the program (50%), and strength of interest in the program (64%). Top factors for choosing virtual interviews were decreased costs (64%), less travel time (53%), and the ability to complete more interviews (53%). 58% of applicants planned to visit at least one program in-person post-interview. The mean total cost of interviews was $122 for virtual and $358 for in-person. Travel for a “second look” visit cost $279. 53% of respondents completed an away rotation, spending an average of $1688 per away rotation.ConclusionWhen presented with the option, applicants chose to interview in-person because of a mutual feeling of portraying and receiving a stronger impression. Candidates chose virtual due to cost reduction and the ability to complete more interviews. The financial savings of virtual interviews should be examined in the context of increased applications, increased interviews, post-interview travel or "second look" experiences, and costs associated with away rotations. Future work is needed to elucidate the role of in-person contact or away rotations on the likelihood of an applicant to interview and match in a largely virtual interview era.

Characteristics Associated with Successful Residency Match in General Surgery.

To evaluate characteristics of matched and unmatched general surgery residency (GSR) applicants. Given the recent change of the United States Medical Licensing Exam Step 1 grading to pass/fail, understanding the factors that influence GSR match success is integral to identifying potential interventions to improve match rates for diverse medical students. Retrospective review of GSR National Residency Matching Program (NRMP) applicant and Accreditation Council for Graduate Medical Education (ACGME) active resident data between 2011 and 2022. Data included application characteristics for United States ("US") and "independent" applicants, factors cited by program directors in the interview and ranking process, paths pursued if applicants went unmatched, and racial/ethnic representation. A total of 9149 US and 3985 independent applicants applied to GSR between 2011 and 2021. Matched versus unmatched applicants had higher step 1 scores (US: 236 vs 218, P = 0.005; independent: 237 vs 228, P = 0.001), higher step 2 scores (US: 248 vs 232, P = 0.006; independent: 245 vs 234, P < 0.001), more likely to belong to alpha omega alpha (US: 17.1% vs 1.6%, P = 0.002) or to attend a top 40 National Institutes of Health-funded school (US: 31.0% vs 19.4%, P = 0.002) compared to unmatched applicants. Program directors heavily factored step 1 and step 2 scores, letters of recommendation, interactions with faculty and trainees, and interpersonal skills when interviewing and ranking applicants. The proportion of active general surgery residents versus applicants was lower for Asians (12.3% vs 20.9%, P < 0.001), Black/African American (5.0% vs 8.8%, P < 0.001), Hispanic/Latino (5.0% vs 9.4%, P = 0.001), and underrepresented in medicine students (10.3% vs 19.1%, P < 0.001). In the pass/fail step 1 era, factors including step 2 score and other subjective metrics may be more heavily weighted in the GSR match process.

Geographic and demographic trends with the initiation of virtual interviews in general surgery: A 7-program evaluation

BackgroundAlthough most general surgery residency interviews remain virtual, the effect of this format remains understudied. Single-institution data have shown an increase in the number of applications received and interviews conducted with virtual interviewing but no change in the geographic backgrounds of interviewed or matched applicants. This study sought to compare national trends in geographic characteristics of general surgery applicants, interviewed applicants, and matched applicants between in-person and virtual application cycles. Study DesignA retrospective review of 7 general surgery residency programs from application years 2016–2019 (in-person) and 2020–2021 (virtual) was conducted. Data collected included birth year, sex, race, medical school state, and contact location at the time of application. Data were analyzed using generalized mixed effects linear models. ResultsA total of 52,742 applicants, 4,550 interviewed applicants, and 329 matched applicants were included. During virtual application cycles, there were no increases in the average number of applicants (P = .25), interviewed applicants (P = .36), or matched (P = .84) applicants per year. Virtual cycles were associated with a larger proportion of interviews conducted with applicants from out-of-state medical schools (P < .01) and listing out-of-state contact locations (P < .01) compared with in-person application cycles. There were no significant geographic differences in matched applicants between virtual and in-person application cycles. ConclusionVirtual application cycles had greater geographic diversity among interviewed applicants. However, similar differences were not seen in the geographic diversity of matched applicants. Additional efforts should focus on why no changes in the geographic diversity of matched applicants were identified.

The Impact of the COVID-19 Pandemic on Geographic Placement of Applicants to General Surgery Residency Programs

COVID-19 greatly influenced medical education and the residency match. As new guidelines were established to promote safety, travel was restricted, visiting rotations discontinued, and residency interviews turned virtual. The purpose of this study is to assess the geographic trends in distribution of successfully matched General Surgery applicants prior to and after the implementation of pandemic guidelines, and what we can learn from them as we move forward. This was a retrospective review of 129 Accreditation Council for Graduate Medical Education (ACGME) accredited, academic General Surgery Residency Programs across 46 states and the District of Columbia. Categorically matched residents' medical schools (i.e., home institutions), medical school states, and medical school regions as defined per the Association of American Medical Colleges (AAMC), were compared to the same geographic datapoints as their residency program. Preliminary residents were excluded. Residents in the 2018, 2019, and 2020 cycles were sub-categorized into the "pre-COVID" group and residents in the 2021 and 2022 applications cycles were sub-categorized into the "post-COVID" group. The percentages of residents who matched at their home institution, in-state, and in-region were examined. Multiple ACGME-accredited, university-affiliated General Surgery Residency Programs across the United States of America. A total of 4033 categorical General Surgery residents were included. Of 4033 categorical residents who matched between 2018 and 2022, 56.1% (n = 2,263) were in the pre-COVID group and 43.9% (n = 1770) were in the post-COVID group. In the pre-COVID group 14.4% (n = 325) of residents remained in-home (IH), 24.4% (n = 553) in-state (IS), and 37.0% (n = 837) in- region (IR), compared to 18.8% IH (n = 333), 27.8% IS (n = 492), and 39.9% IR (n = 706) in the post-COVID group, respectively. Significant increases for IH and IS resident matching at 4.5% and 3.4%, respectively, were noted in the post-COVID period (p < 0.05). The COVID-19 pandemic, and the ensuing changes adopted to promote safety, significantly impacted medical student opportunities and the General Surgery residency application process. General Surgery match data over the last 5 years reveals a statistically significant increase in the percentage of applicants matching at in-home and in-state institutions after the pandemic.

Fluorescence and tracers in surgery: the coming future

The revolution that we are seeing in the world of surgery will determine the way we understand surgical approaches in coming years. Since the implementation of minimally invasive surgery, innovations have constantly been developed to allow the laparoscopic approach to go further and be applied to more and more procedures. In recent years, we have been in the middle of another revolutionary era, with robotic surgery, the application of artificial intelligence and image-guided surgery. The latter includes 3D reconstructions for surgical planning, virtual reality, holograms or tracer-guided surgery, where ICG-guided fluorescence has provided a different perspective on surgery.ICG has been used to identify anatomical structures, assess tissue perfusion, and identify tumors or tumor lymphatic drainage. But the most important thing is that this technology has come hand in hand with the potential to develop other types of tracers that will facilitate the identification of tumor cells and ureters, as well as different light beams to identify anatomical structures. These will lead to other types of systems to assess tissue perfusion without the use of tracers, such as hyperspectral imaging. Combined with the upcoming introduction of ICG quantification, these developments represent a real revolution in the surgical world. With the imminent implementation of these technological advances, a review of their clinical application in general surgery is timely, and this review serves that aim.

Fluorescencia y trazadores en cirugía: el futuro que nos viene

The revolution that we are seeing in the world of surgery will determine the way we understand surgical approaches in coming years. Since the implementation of minimally invasive surgery, innovations have constantly been developed to allow the laparoscopic approach to go further and be applied to more and more procedures. In recent years, we have been in the middle of another revolutionary era, with robotic surgery, the application of artificial intelligence and image-guided surgery. The latter includes 3D reconstructions for surgical planning, virtual reality, holograms or tracer-guided surgery, where ICG-guided fluorescence has provided a different perspective on surgery.ICG has been used to identify anatomical structures, assess tissue perfusion, and identify tumors or tumor lymphatic drainage. But the most important thing is that this technology has come hand in hand with the potential to develop other types of tracers that will facilitate the identification of tumor cells and ureters, as well as different light beams to identify anatomical structures. These will lead to other types of systems to assess tissue perfusion without the use of tracers, such as hyperspectral imaging. Combined with the upcoming introduction of ICG quantification, these developments represent a real revolution in the surgical world. With the imminent implementation of these technological advances, a review of their clinical application in general surgery is timely, and this review serves that aim.

Navigating the couples match: Key challenges and lessons learned from two general surgery applicants

The Couples Match presents unique obstacles and considerations to medical students who are already participating in a rigorous residency application process. We aim to describe the distinct challenges presented by the Couples Match and present advice from our own experience successfully matching into general surgery residency as a couple.

The Relationship Between Program and Applicant Characteristics With Applicant Program Signals in the 2022 Residency Recruitment Cycle: Findings From 3 Specialties.

Continuing increases in application volume have driven a national dialogue to reform the residency recruitment process. Program signaling allows applicants to express interest in a program at the preinterview stage with the goal of helping programs identify applicants with more genuine interest in their programs. This study explored the relationship between program signals and program and applicant characteristics. Participating dermatology, general surgery, and categorical internal medicine (IM) programs and applicants of the 2022 supplemental ERAS application (SuppApp) were included. Data from the SuppApp, the MyERAS Application for Residency Applicants (MyERAS), and the 2020 GME Track Survey were used. Cohen's h was used to determine effect size, and chi-squared was used to determine statistical significance. There was an uneven distribution of signals to programs, with 25% of programs receiving about half of the signals across all 3 specialties. Programs with larger numbers of both residents and applicants received greater numbers of program signals relative to their program density, although this effect was small ( h < 0.50, P < .001). No meaningful differences were seen across genders for any specialty. Only Hispanic applicants in IM sent a higher proportion of signals to programs with more underrepresented in medicine residents than White only applicants (40% vs 26%, h = 0.30, P < .001). Across all specialties, there was a small-to-moderate effect for international medical graduate (IMG) applicants sending a larger proportion of signals to programs with more IMG residents ( h < 0.80, P < .001). This first-year pilot study (i.e., SuppApp) provided initial evidence that supports the feasibility and fairness of program signals in residency selection. As program signals become more common across specialties, future research should continue to evaluate trends in where applicants send signals, and possible relationships between program and application characteristics.

General surgery applicant perspectives: Two years of virtual interview experiences and supplemental application impressions

BackgroundWe sought to evaluate the unique benefits and challenges the virtual recruitment and interviewing platform had on general surgery residency applicants. MethodsApplicants who interviewed for a categorical position at our institution during the 2021 and 2022 Match season were contacted to participate in the anonymous online survey focused on applicant behavior related to the virtual interview format. Data were analyzed using chi-square and paired t-tests. ResultsA response rate of 56.7 ​% (n ​= ​135) was achieved. Applicants accepted a median of 17 (IQR 13–20) interviews in 2021 and 15 (IQR 11–19) interviews in 2022. More than half (54 ​%) of applicants indicated they applied to more programs, and 53 ​% accepted more interviews, because of the virtual format. The greatest advantages of the virtual interviews as cited by applicants were saving money (96.3 ​%), saving time (49.6 ​%), and avoiding travel risks (43.7 ​%). The top limitations of virtual interviews were less exposure to current residents and faculty (61.5 ​%), to the city or location of the program (58.5 ​%), and difficultly comparing programs (57.8 ​%). The 2022 Match cycle included use of the supplemental application; however, 85 ​% of applicants did not feel that the supplemental improved their overall application. Some applicants (20 ​%) who “signaled” programs did not receive an interview offer from any of the programs they signaled. ConclusionThe transition to virtual interviews saved applicants time and money but limited their exposure. Future efforts to maintain virtual interviews will need to be balanced against the intangible benefit of human interaction and observing a program's culture.

Investigating the wear performance of AZ91D magnesium composites with ZnO, MnO, and TiO2 nanoparticles

In recent decades, there has been a notable advancement in the field of bioactive, biodegradable, and biocompatible metallic materials, particularly for applications in general surgery. Among these materials, magnesium alloy-based composites have gained popularity due to their excellent biological properties and adequate strength. However, their resistance to wear is still an area that requires further investigation. Therefore, this study examines the wear properties of stir-ultrasonic-squeeze-casted magnesium (AZ91D) composites, incorporating distinct nanoparticles such as ZnO, MnO, and TiO2. The Evaluation-based Distance from Average Solution (EDAS) approach is used to determine the optimal parameters. Additionally, an Analysis of Variance (ANOVA) is conducted to identify the crucial factors influencing the responses. The effect of process factors on the wear rate and Coefficient of Friction (COF) is then investigated using response surface plots. The confirmation assessments reveal that the optimal parameter conditions for the tribo process comprise a 50.0018 N applied load, a 1.4998 m/s sliding velocity, and the AZ91D + 1% TiO2 (ATO) composite utilization. The ANOVA findings demonstrate that the applied load significantly contributes to 67.3% of the wear performance. Subsequently, after determining the optimal condition, it is observed that the ATO composite, when exposed to temperatures above 150 °C, exhibits an abrupt increase in wear rate and COF due to the degradation of grain strength and the dissolution of the β-phase within the composite.

Intern Experience Reflects Information Gathered During the Virtual Interview Process

The onset of the coronavirus 2019 (COVID-19) pandemic brought many changes to the residency application process including transitioning to a virtual interview platform, which continues today. The transition brought many concerns from general surgery applicants about their ability to obtain adequate information about a program virtually. We sought to characterize how information presented by programs during the first ever virtual interview cycle matched the experience of general surgery interns after training at a program for 1 year. In May of 2022, a survey was distributed to 243 program directors who were asked to forward it to their general surgery categorical interns who matched during the 2021 virtual match cycle. Demographics, resources used to determine an impression of a program, and correlations between information presented virtually and what was subsequently experienced as an intern were collected. Forty-six program directors confirmed forwarding the survey to their categorical interns. A total of 102 general surgery interns completed the survey. Most interns (88.2%) agreed that their experience matched expectations based on information received through the virtual interview process and 98% of interns were satisfied with their experience at their training program. Interviews with faculty (40.0%), residents (68.0%) and the program web site (29.0%) were the top 3 resources used to create the most accurate impression of a program. Interns felt they were well informed during the virtual interview experience about support from fellow residents (84.3%), culture (73.0%), surgical volume (72.5%), and intern operative experience (71.6%). In addition, 65.7% of participants thought they were able to obtain a good understanding of the program's culture from the virtual process. However, 16.7% thought that their program unintentionally misrepresented aspects of the training program. The faculty and residency interviews were the most important factors in program ranking and most participants agreed that their virtual interview experience matched their expectations during their intern year. Most interns felt they were able to obtain a good understanding of the program's culture from the virtual process. In addition, a majority of interns felt well informed during the interview on aspects ranging from surgical volume, autonomy, and work hours to support from faculty and residents. If virtual interviews are to continue, residents can be satisfied that information gathered virtually will match the reality of their training. Programs should continue to make every effort to present their program realistically.

Single-port plus one port subcostal robotic-assisted minimally invasive McKewon esophagectomy using the daVinci Single-Port surgical system.

Abstract The daVinci Single-Port (SP) surgical system has received approval for application in general thoracic surgery in some countries. However, until recently, it has only been used for simple procedures. Minimally invasive oesophagectomy is a technically complex procedure, but some cadaveric experiments have shown the feasibility of the SP system in oesophagectomy. Herein, we present our first case of single-port plus one port subcostal robotic-assisted minimally invasive Mckeown oesophagectomy (McKeown RAMIE) using the SP system in a patient with oesophageal cancer. This article contains information and tips on performing single-port subcostal McKeown RAMIE using the SP system.

Program Director and Faculty Attitudes Towards Openly Non-Heterosexual General Surgery Applicants

Wothe, Jillian; Kalland, Krystina R BS; Seltzer, Benjamin K PhD; Kohn, Julia MD; Brunsvold, Melissa Elizabeth MD, FACS Author Information

Virtual Mentoring: A Novel Approach to Facilitate Medical Student Applications to General Surgery Residency

The COVID-19 pandemic rapidly altered the landscape of medical education, particularly disrupting the residency application process and highlighting the need for structured mentorship programs. This prompted our institution to develop a virtual mentoring program to provide tailored, one-on-one mentoring to medical students applying to general surgery residency. The aim of this study was to examine general surgery applicant perception of a pilot virtual mentoring curriculum. The mentorship program included student-tailored mentoring and advising in 5 domains: resume editing, personal statement composition, requesting letters of recommendation, interview skills, and residency program ranking. Electronic surveys were administered following ERAS application submission to participating applicants. The surveys were distributed and collected via a REDCap database. Eighteen out of 19 participants completed the survey. Confidence in a competitive resume (p = 0.006), interview skills (p < 0.001), obtaining letters of recommendation (p = 0.002), personal statement drafting (p < 0.001), and ranking residency programs (p < 0.001) were all significantly improved following completion of the program. Overall utility of the curriculum and likelihood to participate again and recommend the program to others was rated a median 5/5 on the Likert scale (5 [IQR 4-5]). Confidence in the matching carried a premedian 66.5 (50-65) and a postmedian 84 (75-91) (p = 0.004). Following the completion of the virtual mentoring program, participants were found to be more confident in all 5 targeted domains. In addition, they were more confident in their overall ability to match. General Surgery applicants find tailored virtual mentoring programs to be a useful tool allowing for continued program development and expansion.

The Perception of Surgery Program Directors of Residency Applicants From Longitudinal Integrated Curriculum Medical Schools: A Survey of the Association of Program Directors in Surgery Members.

Research statement This study explores whether longitudinal integrated clerkship (LIC) students are competitive general surgery applicants and if they are perceived as adequately prepared for general surgery residency compared to traditional block rotation (BR) students. Background/relevance of the study There is increasing interest in LIC models of clinical education versus BR models. LIC students have been shown to perform similarly on examinations to BR students. However, while LICs seem well suited for students pursuing primary care specialties, little is known about how this approach impacts clinical education for surgery. Design and methods An electronic survey was prepared and approved by the Association of Program Directors in Surgery (APDS) and our university's institutional review board (IRB). Ten multiple-choice questions were administered along with an option for narrative comments. Surveys were sent over a one-month period to members of APDS Listserv. Returned emails were de-identified, and the results were tabulated. Results From 43 responses, the majority identified as program directors (PDs) (65%) and reported being somewhat familiar or very familiar with LICs (90%). When asked about the statement "LIC students are prepared for surgical residency," 22% "disagreed" or "strongly disagreed."When asked"How would you rank a LIC prospective applicant in comparison to a BR student?"35% responded that they would rank the LIC student lower or not at all. Of the respondents, 47% reported that they have current residents who were LIC students. Most of these residents (65%)are graded as "average"for current performance. Conclusions The results suggest that medical students who are trained using LICs may be disadvantaged when applying to general surgery residencies. Interpretation is limited by the small number of respondents, and it only reflects the opinions of active APDS Listserv members. Further study is needed to confirm these findings and elucidate the basis of perceived deficiencies in LICs. Students from these schools should be advised to obtain additional surgery experience.

A Primer on General Surgery Applicants Who Have Graduated From Indian Medical Schools.

Background: Graduates of Indian medical schools account for the greatest proportion of non-US born international medical graduates applying to general surgery residency programs.Purpose: Provide information to facilitate fair and holistic review of applicants from Indian medical schools.Research Design: Comprehensive review of the Indian medical education system, including history, regulatory agencies, medical school admission, curriculum, cultural differences, immigration issues, and outcomes after residency.Results: The Indian medical education system is one of the world's oldest. The number of medical schools and graduates continues to increase. Medical school admission criteria are variable. Recent regulatory changes have improved the quality of applicants entering the US. Emphasis on academic performance over volunteerism as well as communication styles differ from US graduates. The success of graduates during and after residency is well documented.Conclusions: Understanding the differences in the US and Indian medical education systems will provide a basis for the fair evaluation of applicants.

Multi-institutional surgical outcomes of robotic single-port surgery: a Korean experience.

The da Vinci single-port system (SPS) has been applied in several fields of surgery; however, only a few studies have reported its applications in general thoracic surgery. This retrospective study aimed to investigate the multi-institutional experiences of applications of SPS in Korea. The surgical outcomes of three institutions in Korea were collected and retrospectively reviewed. A total of 39 surgeries were performed using SPS without conversion to multiport surgery. The patients included 16 males, and the mean age was 54.2±12.4 years. The most common pathological diagnoses were thymoma (18 cases) and benign cystic lesions (10 cases). The approach used for SPS was subxiphoid, subcostal, and intercostal in 26, 10, and 3 cases, respectively. All patients underwent the surgeries without postoperative complications. The median operation time and peak pain score were 121.4±45.4 min and 3.1±1.1. The median duration of in situ chest tube and hospital stay was 1.3±0.6 and 2.9±1.2 days, respectively. The application of SPS for general thoracic surgery was safe and feasible, whereas its applications remain limited to simple cases. To enable the widespread use of SPS surgery, alleviation of cost-related problems and technical improvement of SPS for complex procedures are required.

Predicting General Surgery Match Outcomes Using Standardized Ranking Metrics

IntroductionObjective measurements for applicant ranking are becoming increasingly important, not only to help address the growing number of general surgery applicants each year but also to minimize bias and ensure consistency. We assessed if our general surgery applicant scoring system was an effective tool for accurately predicting the results of the resident match. MethodsA retrospective review of applicant rank lists from 2017 to 2020 was conducted. Applicants were ranked based on the sum of preinterview and interview scores. The preinterview score is an objective metric related to the applicant's academic portfolio. The interview score is a standardized score based on interview performance. We reviewed match results from ranked candidates and categorized them as academic categorical (AC), community categorical (CC), preliminary surgical (PS), nonsurgical specialty (NS), or unmatched (UM) positions. ResultsA total of 378 applicants were interviewed. Forty-nine percent matched into AC, 22% into CC, 11% into PS, and 5% into NS positions, while 13% of the interviewees were UM. Applicants who matched into AC positions had significantly higher preinterview and interview scores than applicants in other categories. Applicants who matched into CC positions had significantly higher interview scores than those categorized as UM, but their preinterview scores did not differ significantly from the UM group. Applicants who did not match into a categorical position (PS, NS, or UM) did not have significantly different preinterview or interview scores from one another. ConclusionsOur standardized scoring system was effective in stratifying which applicants would match into categorical general surgery residency programs.

Implementation of Enhanced Recovery After Surgery Protocol in a Second-level Hospital

Background: Enhanced recovery after surgery (ERAS) became standard perioperative care in the western world. However, little is known about the implementation of fast-track pathways (FTP) in developing countries. The objectives of the study were to assess the feasibility of the FTP program and adherence to the ERAS protocol in general surgery patients implemented in low-resource setting. Methods: In this retrospective, observational study, we evaluated perioperative care for elective and emergency surgical population changed in accordance with the ERAS program in a second-level hospital in Zambia. Ninety-eight patients aged two weeks to 87 years (median 32 years) with a male to female ratio of 2.3:1 and categorised by the American Society of Anaesthesiologists (ASA) in classes I to IV were included. Outcomes of interest were functional recovery, postoperative complications, length of hospital stay, and compliance with the protocol. Results: All elements of the ERAS protocol, including minimal access surgery (through mini-laparotomy incisions) and accelerated postoperative care, were employed. A successful recovery with discharge home by day 4 after the operation and the absence of complications and readmissions was achieved in 45.5% of patients. The postoperative period was complicated in 18.8% of cases, with a total mortality rate of 6.3%. The overall adherence level to the protocol was 72.2%. The highest levels of adaptation (≥95%) were reported for preoperative stratification, antimicrobial prophylaxis, modification of preanaesthetic medications, and prevention of intraoperative hypothermia. The poor compliance to the program was recorded for fasting and carbohydrate loading before surgery and postoperative thromboprophylaxis (17.9% and 21.4%, respectively). Conclusion: The study indicates that the employment of the ERAS program for the general surgery population at a second-level hospital is feasible and safe. It is possible to achieve a high level of adherence to the ERAS pathway in a resource-limited environment. A reasonable modification of the protocol can bring additional clinical benefits. Integrating elements of FTP into perioperative care and including the ERAS program in postgraduate education in developing nations is recommended. Further studies are needed, first, to frame ERAS pathways for application in emergency general surgery, and second, to present the local initiatives and identify barriers to the implementation of FTP in low-income countries. Doi: 10.28991/SciMedJ-2022-04-04-04 Full Text: PDF