TY - JOUR
T1 - Impact of Research Training on Performance in General Surgery Residency
AU - Mikhail, Alexandre
AU - Connor, Ashton A.
AU - Ahmed, Najma
N1 - Funding Information:
Prior studies of dedicated research time during residency have found positive outcomes such as higher proportion matching into fellowship training programs, greater pursuit of academic careers and more successful attainment of grant funding. 3 - 6 However, there is a paucity of research focusing on the direct effect of dedicated research time on surgical training, such as the acquisition of knowledge and judgment. The literature consists largely of qualitative research on the perspectives of attendings and trainees. Resident self-report that participation in dedicated research programs leads to a decay in clinical aptitude and technical skill. 7 Faculty members share this perception, describing residents as less technically proficient after taking dedicated time for research. 8
Publisher Copyright:
© 2021 Association of Program Directors in Surgery
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Introduction: It is common for North American surgical trainees to interrupt clinical training to complete 2 or more years of research training. The impact of this practice on surgical aptitudes is unknown. The University of Toronto has large general surgery and surgeon scientist training programs. We compared the examination scores of general surgery residents in continuous clinical training with those of residents whose training was interrupted by research. Methods: We collected anonymized scores obtained at written and oral annual in-training examinations by general surgery residents at the University of Toronto from 2011 to 2016, inclusive. The written exam assessed knowledge, while the oral exam assessed judgment. Residents were dichotomized into continuous versus non-continuous clinical training streams. We compared performance prior to, during, and following divergence for research training both within and between the 2 groups. Results: At the junior resident level, future enrollment in research training was associated with higher examination performance (Pwritten = .003). Annual scores plateaued during research training, while scores of residents who continued in continuous clinical training improved year over year (Pwritten = .009). Non-continuous stream resident exam scores remained stagnant after 1 year then improved in the second year after return to clinical training (Pwritten = .00007). Scores obtained in the final year of residency training did not significantly differ between residents who underwent continuous versus non-continuous clinical training. Results from written and oral exams trended concordantly. Conclusions: We demonstrate that interruption of clinical training for 2 or more years of research is associated with a stagnation of performance on annual in-training examinations assessing both knowledge and judgment. This phenomenon is followed by an eventual catching-up after at least 2 years return to full-time clinical training. This may inform residency program curriculum design.
AB - Introduction: It is common for North American surgical trainees to interrupt clinical training to complete 2 or more years of research training. The impact of this practice on surgical aptitudes is unknown. The University of Toronto has large general surgery and surgeon scientist training programs. We compared the examination scores of general surgery residents in continuous clinical training with those of residents whose training was interrupted by research. Methods: We collected anonymized scores obtained at written and oral annual in-training examinations by general surgery residents at the University of Toronto from 2011 to 2016, inclusive. The written exam assessed knowledge, while the oral exam assessed judgment. Residents were dichotomized into continuous versus non-continuous clinical training streams. We compared performance prior to, during, and following divergence for research training both within and between the 2 groups. Results: At the junior resident level, future enrollment in research training was associated with higher examination performance (Pwritten = .003). Annual scores plateaued during research training, while scores of residents who continued in continuous clinical training improved year over year (Pwritten = .009). Non-continuous stream resident exam scores remained stagnant after 1 year then improved in the second year after return to clinical training (Pwritten = .00007). Scores obtained in the final year of residency training did not significantly differ between residents who underwent continuous versus non-continuous clinical training. Results from written and oral exams trended concordantly. Conclusions: We demonstrate that interruption of clinical training for 2 or more years of research is associated with a stagnation of performance on annual in-training examinations assessing both knowledge and judgment. This phenomenon is followed by an eventual catching-up after at least 2 years return to full-time clinical training. This may inform residency program curriculum design.
KW - General surgery, Training
KW - Medical Knowledge
KW - Practice-Based Learning and Improvement
KW - Research training
KW - Resident performance
KW - Surgical education
KW - Systems-Based Practice
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U2 - 10.1016/j.jsurg.2021.10.006
DO - 10.1016/j.jsurg.2021.10.006
M3 - Article
C2 - 34824045
AN - SCOPUS:85119595674
SN - 1931-7204
VL - 79
SP - 342
EP - 348
JO - Journal of Surgical Education
JF - Journal of Surgical Education
IS - 2
ER -