Tutorial Assistance for Board Certification in Surgery: Frequency, Associated Time and Cost
- 126 Downloads
Tutorial assistance is related to extra time and cost, and the hospitals’ financial compensation for this activity is under debate. We therefore aimed at quantifying the extra time and resulting cost required to train one surgical resident in the operating theatre for board certification in Switzerland as an example of a training curriculum involving several surgical subspecialties. Additionally, we intended to quantify the percentage of tutorial assistance.
We analysed 200,700 operations carried out between 2008 and 2012. Median duration of procedure categories was calculated according to four different seniority levels. The extra time if the procedure was performed by residents, and resulting cost were analysed. The percentage of procedures carried out by residents as compared to more experienced surgeons was assessed over time.
On average, residents performed about a third of all operations including typical teaching procedures like appendectomies. An increase in duration and cost of well-defined procedures categories, e.g. cholecystectomies was demonstrated if a resident performed the procedure. In less well-defined categories, residents seemed to perform less difficult procedures than senior consultants resulting in shorter durations of surgery.
The financial impact of tutorial assistance is important, and solutions need to be found to compensate for this activity. The low percentage of procedures performed by trainees may make it difficult to fulfil requirements for board certification within a reasonable period of time. This should be addressed within the training curriculum.
KeywordsBoard Certification Major Amputation Laparoscopic Hernia Repair Senior Consultant Tertiary Academic Care Centre
The authors thank Luzi Rageth and the AQC for providing the data set and Eileen Walliser for proofreading.
Compliance with ethical standards
Conflict of interest
Rachel Rosenthal is an employee of F. Hoffmann-La Roche Ltd. since 1 May 2014. The present study was conducted before she joined F. Hoffmann-La Roche Ltd. and has no connection to her employment by the company. Rachel Rosenthal continues to be affiliated to the University of Basel.
- 6.Bartkowski R (2009) Problem DRG: does medical training fall by the wayside? Swiss knife 3:8–10Google Scholar
- 7.Swiss Association for Quality Assurance in Surgery (AQC). http://www.aqc.ch. Accessed 20 July 2016
- 8.CHOP 2014. http://www.bfs.admin.ch/bfs/portal/de/index/infothek/nomenklaturen/blank/blank/chop/02/05.html. Accessed 1 May 2016
- 9.Newson R (2006) Confidence intervals for rank statistics: percentile slopes, differences, and ratios. Stata J 6(4):497–520Google Scholar
- 22.Joint Committee on Surgical training. JCST quality indicatiors. http://www.jcst.org/quality-assurance/jcst-quality-indicators-and-trainee-survey. Accessed 28 Dec 2015
- 23.ACGME Program Requirements for Graduate Medical Education in General Surgery (2016) http://www.acgme.org/portals/0/pfassets/programrequirements/440_general_surgery_2016.pdf. Accessed 21 July 2016