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World Journal of Surgery

, Volume 41, Issue 8, pp 1950–1960 | Cite as

Tutorial Assistance for Board Certification in Surgery: Frequency, Associated Time and Cost

  • Robert MecheraEmail author
  • Salome Dell-Kuster
  • Marco von Strauss und Torney
  • Igor Langer
  • Markus Furrer
  • Heiner C. Bucher
  • Rachel Rosenthal
Original Scientific Report

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Board Certification Major Amputation Laparoscopic Hernia Repair Senior Consultant Tertiary Academic Care Centre 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

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.

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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Robert Mechera
    • 1
    Email author
  • Salome Dell-Kuster
    • 1
    • 2
  • Marco von Strauss und Torney
    • 1
    • 3
  • Igor Langer
    • 4
    • 5
  • Markus Furrer
    • 6
  • Heiner C. Bucher
    • 2
  • Rachel Rosenthal
    • 1
  1. 1.Department of SurgeryUniversity Hospital of BaselBaselSwitzerland
  2. 2.Basel Institute for Clinical Epidemiology and BiostatisticsUniversity Hospital of BaselBaselSwitzerland
  3. 3.Department of SurgeryCantonal Hospital AarauAarauSwitzerland
  4. 4.Department of SurgeryLindenhof Hospital BernBernSwitzerland
  5. 5.Swiss Association for Quality Assurance in Surgery (AQC)ZurichSwitzerland
  6. 6.Department of SurgeryCantonal Hospital GraubündenChurSwitzerland

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