Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Fundamentals of Becoming a Safe and Independent Surgeon (From First Assistant to Skilled Educator)

  • Chapter
  • First Online:
Fundamentals of General Surgery

  • 2857 Accesses

Abstract

General surgery residency training, governed by the Accreditation Council for Graduate Medical Education (ACGME) in collaboration with the American Board of Surgery (ABS), continues to evolve to meet the needs of the present-day healthcare climate and to address specific areas of deficiency so that graduating surgeons can be competent and proficient. Despite these efforts, the transition to independent surgical practice is difficult from a personal and professional perspective due to newfound operative autonomy and practice management. Key principles can be applied to alleviate these challenges and include formal transition to practice programs, finding a valuable mentor, setting up for early success by taking on low-complexity cases, developing collaborative relationships, and adhering to society guidelines.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Suggested Readings

  • Mattar SG, Alseidi AA, Jones DB, Jeyarajah DR, Swanstrom LL, Aye RW, et al. General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors. Ann Surg. 2013;258:440–9.

    Article  PubMed  Google Scholar 

  • Cogbill TH, Shapiro SB. Transition from training to surgical practice. Surg Clin North Am. 2016;96:25–33.

    Article  PubMed  Google Scholar 

  • Klingensmith ME, Cogbill TH, Luchette F, Biester T, Samonte K, Jones A. Factors influencing the decision of surgery residency graduates to pursue general surgery practice versus fellowship. Ann Surg. 2015;262:449–55.

    Article  PubMed  Google Scholar 

References

  1. Grillo HC. Edward D. Churchill and the “rectangular” surgical residency. Surgery. 2004;136:947–52.

    Article  PubMed  Google Scholar 

  2. Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in General Surgery. Accreditation Council for Graduate Medical Education. 2017. http://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/440_general_surgery_2017-07-01_TCC.pdf. Accessed 13 Mar 2017.

  3. Accreditation Council for Graduate Medical Education: Milestones. 2017. http://www.acgme.org/What-We-Do/Accreditation/Milestones/Overview. Accessed 13 Mar 2017.

  4. Review Committee for Surgery. Defined Category Minimum Numbers: General Surgery Effective for Program Graduates Beginning Academic Year 2017–2018. Accreditation Council for Graduate Medical Education. 2016. https://www.acgme.org/Portals/0/UPDATED_DEFINED_CATEGORY_MINIMUM_NUMBERS_EFFECTIVE_ACADEMIC_YEAR_2017-2018_GENERAL_SURGERY.pdf. Accessed 13 Mar 2017.

  5. The American Board of Surgery: General Surgery: Training Requirements. 2017. http://www.absurgery.org/default.jsp?certgsqe_training. Accessed 13 Mar 2017.

  6. Mattar SG, Alseidi AA, Jones DB, Jeyarajah DR, Swanstrom LL, Aye RW, et al. General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors. Ann Surg. 2013;258:440–9.

    Article  PubMed  Google Scholar 

  7. Klingensmith ME, Cogbill TH, Luchette F, Biester T, Samonte K, Jones A. Factors influencing the decision of surgery residency graduates to pursue general surgery practice versus fellowship. Ann Surg. 2015;262:449–55.

    Article  PubMed  Google Scholar 

  8. Campbell RJ, El-Defrawy SR, Gill SS, Whitehead M, Campbell EL, Hooper PL. New surgeon outcomes and the effectiveness of surgical training: a population-based cohort study. Ophthalmology. 2017;124:532–8.

    Article  PubMed  Google Scholar 

  9. Watanabe Y, Madani A, Bilgic E, McKendy KM, Enani G, Ghaderi I, et al. Don’t fix it if it isn’t broken: a survey of preparedness for practice among graduates of Fellowship Council-accredited fellowships. Surg Endosc. 2016. https://doi.org/10.1007/s00464-016-5231-0.

  10. Gearhart SL, Wang MH, Gilson MM, Chen B, Kern DE. Teaching and assessing technical proficiency in surgical subspecialty fellowships. J Surg Educ. 2012;69:521–8.

    Article  PubMed  Google Scholar 

  11. Klingensmith ME, Cogbill TH, Samonte K, Jones A, Malangoni MA. Practice administration training needs of recent general surgery graduates. Surgery. 2015;158:773–6.

    Article  PubMed  Google Scholar 

  12. Cogbill TH, Shapiro SB. Transition from training to surgical practice. Surg Clin North Am. 2016;96:25–33.

    Article  PubMed  Google Scholar 

  13. Novick RJ, Lingard L, Cristancho SM. The call, the save, and the threat: understanding expert help-seeking behavior during nonroutine operative scenarios. J Surg Educ. 2015;72:302–9.

    Article  PubMed  Google Scholar 

  14. American College of Surgeons: ACS Communities. 2017. http://acscommunities.facs.org/home. Accessed 9 Apr 2017.

  15. International Hernia Collaboration Facebook group. 2017. https://www.facebook.com/groups/herniacollab/. Accessed 9 Apr 2017.

  16. Mathur S, Lin SY. The learning curve for laparoscopic inguinal hernia repair: a newly qualified surgeon perspective. J Surg Res. 2016;205:246–51.

    Article  PubMed  Google Scholar 

  17. Celio AC, Kasten KR, Brinkley J, Chung AY, Burruss MB, Pories WJ, et al. Effect of surgeon volume on sleeve gastrectomy outcomes. Obes Surg. 2016;26:2700–4.

    Article  PubMed  Google Scholar 

  18. Celio AC, Kasten KR, Burruss MB, Pories WJ, Spaniolas K. Surgeon case volume and readmissions after laparoscopic Roux-en-Y gastric bypass: more is less. Surg Endosc. 2017;31:1402–6.

    Article  PubMed  Google Scholar 

  19. Hata T, Motoi F, Ishida M, Naitoh T, Katayose Y, Egawa S, et al. Effect of hospital volume on surgical outcomes after pancreaticoduodenectomy: a systematic review and meta-analysis. Ann Surg. 2016;263:664–72.

    Article  PubMed  Google Scholar 

  20. Studnicki J, Fisher JW, Tsulukidze MM, Taylor YJ, Salandy S, Laditka JN. Career phase of board-certified general surgeons: workload composition and outcomes. Arch Surg. 2011;146:1307–13.

    Article  PubMed  Google Scholar 

  21. Goodenough CJ, Ko TC, Kao LS, Nguyen MT, Holihan JL, Alawadi Z, et al. Development and validation of a risk stratification score for ventral incisional hernia after abdominal surgery: hernia expectation rates in intra-abdominal surgery (the HERNIA project). J Am Coll Surg. 2015;220:405–13.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Poruk KE, Hicks CW, Trent Magruder J, Rodriguez-Unda N, Burce KK, Azoury SC, et al. Creation of a novel risk score for surgical site infection and occurrence after ventral hernia repair. Hernia. 2017;21:261–9.

    Article  CAS  PubMed  Google Scholar 

  23. Basta MN, Fischer JP, Wink JD, Kovach SJ. Mortality after inpatient open ventral hernia repair: developing a risk stratification tool based on 55,760 operations. Am J Surg. 2016;211:1047–57.

    Article  PubMed  Google Scholar 

  24. Pedroso-Fernandez Y, Aguirre-Jaime A, Ramos MJ, Hernández M, Cuervo M, Bravo A, et al. Prediction of surgical site infection after colorectal surgery. Am J Infect Control. 2016;44:450–4.

    Article  PubMed  Google Scholar 

  25. Qu H, Liu Y, Bi DS. Clinical risk factors for anastomotic leakage after laparoscopic anterior resection for rectal cancer: a systematic review and meta-analysis. Surg Endosc. 2015;29:3608–17.

    Article  PubMed  Google Scholar 

  26. Connelly TM, Tappouni R, Mathew P, Salgado J, Messaris E. Risk factors for the development of an incisional hernia after sigmoid resection for diverticulitis: an analysis of 33 patients, operative and disease-associated factors. Am Surg. 2015;81:492–7.

    PubMed  Google Scholar 

  27. Castagno C, Varetto G, Quaglino S, Frola E, Scozzari G, Bert F, et al. Acute kidney injury after open and endovascular elective repair for infrarenal abdominal aortic aneurysms. J Vasc Surg. 2016;64:928–33.

    Article  PubMed  Google Scholar 

  28. Bennett KM, Levinson H, Scarborough JE, Shortell CK. Validated prediction model for severe groin wound infection after lower extremity revascularization procedures. J Vasc Surg. 2016;63:414–9.

    Article  PubMed  Google Scholar 

  29. Haskins IN, Amdur R, Sarani B, Vaziri K. Congestive heart failure is a risk factor for venous thromboembolism in bariatric surgery. Surg Obes Relat Dis. 2015;11:1140–5.

    Article  PubMed  Google Scholar 

  30. Benedix F, Poranzke O, Adolf D, Wolff S, Lippert H, Arend J, et al. Staple line leak after primary sleeve gastrectomy-risk factors and mid-term results: do patients still benefit from the weight loss procedure? Obes Surg. 2017. https://doi.org/10.1007/s11695-017-2543-7.

  31. Fathy O, Wahab MA, Elghwalby N, Sultan A, EL-Ebidy G, Hak NG, et al. 216 cases of pancreaticoduodenectomy: risk factors for postoperative complications. Hepato-Gastroenterology. 2008;55:1093–8.

    PubMed  CAS  Google Scholar 

  32. Guillaud A, Pery C, Campillo B, Lourdais A, Sulpice L, Boudjema K. Incidence and predictive factors of clinically relevant bile leakage in the modern era of liver resections. HPB. 2013;15:224–9.

    Article  PubMed  PubMed Central  Google Scholar 

  33. American Society of Colon and Rectal Surgeons Clinical Practice Guidelines. 2017. https://www.fascrs.org/physicians/clinical-practice-guidelines. Accessed 9 Apr 2017.

  34. Eastern Association for the Surgery of Trauma Practice Management Guidelines. 2017. https://www.east.org/education/practice-management-guidelines. Accessed 9 Apr 2017.

  35. Society of American Gastrointestinal and Endoscopic Surgeons Safe Cholecystectomy Program. 2017. https://www.sages.org/safe-cholecystectomy-program/. Accessed 9 Apr 2017.

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Stony Brook Medicine, Stony Brook, NY, USA

    Nabeel R. Obeid & Konstantinos Spaniolas

Authors
  1. Nabeel R. Obeid
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Konstantinos Spaniolas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Konstantinos Spaniolas .

Editor information

Editors and Affiliations

  1. Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA

    Francesco Palazzo

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Obeid, N.R., Spaniolas, K. (2018). Fundamentals of Becoming a Safe and Independent Surgeon (From First Assistant to Skilled Educator). In: Palazzo, F. (eds) Fundamentals of General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-75656-1_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-75656-1_22

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-75655-4

  • Online ISBN: 978-3-319-75656-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation