Exploring Gender Diversity in Canadian Surgical Residency Leadership.

OBJECTIVE: Studies in the United States demonstrate a low proportion of cisgender women in medical leadership. No research exists about the prevalence of transgender people in medical leadership. The objective of this study was to evaluate gender representation within Canadian surgical training leadership. DESIGN: This study represents a survey based exploratory analysis and literature review. Associations between gender and leadership position, surgical subspecialty, years in practice and leadership role, province of work, and age were calculated using Chi squared goodness of fit and independence tests. SETTING: The study was based out of the University of British Columbia in Vancouver and included all Canadian surgical training programs. PARTICIPANTS: Participants were identified using the Canadian Resident Matching Service and program websites. All prospective respondents (359) were emailed an encrypted survey link. RESULTS: The survey response rate was 65/359 responses (18%). The overall gender distribution was cis men (n = 36, 56.5%), cis women (n = 26, 40%), nonbinary (n = 1, 1.5%), agender (n = 1, 1.5%) and nonresponse (n = 1, 1.5%). Sixty-three percent of program directors were cis men, 33% were cis women and 4% were agender. Sixty-seven percent of associate program directors were cis women and 33% were cis men. Sixty-five percent of division leads were cis men, 29% were cis women, and 6% were nonbinary. There were more cis women in general surgery leadership than expected (df = 1, N = 20, x2 = 11.05, p ≤ 0.001). No statistically significant associations between gender identity/modality, leadership role, province, or age were found using chi squared tests. CONCLUSIONS: Cis men continue to outnumber all others in surgical training leadership. More cis women than expected work in general surgery training leadership. However, these findings must be interpreted with caution considering the low survey response rate and the greater proportion of cis women respondents compared to cis women surgeons. There is a marked absence of binary-identified trans people in surgical training leadership in Canada, however a small number of nonbinary and agender people are present.

Residency Wellness: A Historical Narrative Review.

INTRODUCTION: The structure of medical residency in the United States has experienced significant changes, paralleling advances in medical science and education. While these changes have enhanced medical training, they have introduced challenges, particularly in resident wellness. The well-being of residents is critical for patient care and the healthcare system. This review aims to provide an overview of the historical trends in medical residency, focusing on the evolution of resident wellness and its associated challenges. METHODS: A narrative review was conducted, examining the evolution and challenges of medical residency with an emphasis on resident wellness. An exhaustive literature search on January 25, 2024 was conducted across PubMed, Web of Science, and Google Scholar. The search utilized keywords related to medical residency, wellness, and educational reforms. Articles were selected based on relevance and robust evidence, and information was organized into thematic categories for narrative synthesis. RESULTS: The search yielded 57 publications that met the inclusion criteria. Historical trends revealed a shift from an apprenticeship model to formalized training programs, with each phase bringing unique challenges to resident wellness. The Flexner Report's influence on standardizing medical education, the rise of modern residency programs, and the recognition of burnout as a significant issue were key developments. Policy changes, technological impacts, and the COVID-19 pandemic have further shaped residency training and wellness. Studies highlight the need for interventions addressing burnout and promoting wellness, with varied approaches across specialties and institutions. CONCLUSION: Residency burnout has been a growing concern since the 1970s, exacerbated by advancements in medicine, technology, and recent global events like the COVID-19 pandemic. Although awareness has increased, the need remains to address burnout and promote wellness during residency. Further research is warranted to develop effective interventions and adapt training to meet the evolving needs of residents.

Not taught in medical school but needed for the clinical job - leadership, communication and career management skills for final year medical students.

BACKGROUND: Starting the first job as a young physician is a demanding challenge. Certain skills are important to master this transformation that go beyond the theoretical knowledge and practical skills taught in medical school. Competencies such as communication, leadership and career management skills are important to develop as a young physician but are usually not sufficiently taught in medical school in a structured and comprehensive way. METHODS: We performed an online survey among final year medical students regarding how they perceive their current competency level in communication, leadership and career management skills. We also assessed how they rate the importance to acquire these competencies and the current emphasis during their medical school education regarding these topics. RESULTS: Of 450 final year medical students 80 took part in the voluntary survey and 75 complete datasets were returned (16.7%). The majority of respondents rated different communication skills, leadership skills and career management skills as important or very important for their later clinical work. However, most students felt to be poorly or very poorly prepared by the current medical school curriculum, especially for certain leadership and career management skills. Overall, 90.7% of participants expressed interest in an additional educational course that covers subjects of communication, leadership and career management skills during the later stage of medical school, preferably as a hybrid in-person session that also offers synchronous online participation. CONCLUSIONS: The results of the survey express the need to address communication, leadership and career management skills in the medical curriculum to be better prepare students for the demands of residency and their further course as physicians. An educational format during the final year of medical school may be suitable to address mentioned topics in the framework of clinical practical exposure.

Novel Image-Guided Simulator for Transcervical Intralaryngeal Injection Training.

OBJECTIVE(S): To assess the impact of a novel 3D-printed simulation model with Brainlab Image Guidance on enhancing otolaryngology residents' skills and confidence in performing transcervical intralaryngeal injection (TII) compared with conventional training methods. METHODS: Utilizing a 3D-printed larynx model derived from computed tomography (CT) scans, this study involved 16 otolaryngology residents divided into two groups for TII training: one with Brainlab Image Guidance (LMIG) and the other without (LM). Pre- and post-training evaluations measured participants' confidence while the Brainlab system measured the accuracy of their needle placements. RESULTS: After training, participants exhibited a significant increase in confidence with an average rise from 1.56 to 2.75 on a 5-point scale. The LMIG group outperformed the LM group in accuracy achieving statistically significant reductions in target distances after training (3.5 mm right, 3.6 mm left). The LMIG also demonstrated a significantly greater increase in procedural confidence over the LM group after training. CONCLUSION: The TII laryngeal model with Brainlab Image Guidance significantly improves procedural confidence and accuracy among otolaryngology residents, signifying potential advantage over a more conventional training approach. The model's realistic tactile and live instrument positioning feedback augments the process of surgical skill refinement in a controlled, risk-free, simulation environment. LEVEL OF EVIDENCE: NA Laryngoscope, 2024.

The impact of perfectionism on suicidal ideation among medical residents in Iran: the mediating role of psychological distress.

BACKGROUND: Among medical residents, suicide is the second most prevalent cause of mortality. In Iran, the suicide of medical residents has become one of the most important challenges. This study aimed to investigate the mediating role of psychological distress in the relationship between perfectionism and suicidal ideation among medical residents in Iran. METHODS: This research was a descriptive-correlational study based on structural equation modeling. The statistical population of the present research included all the residents in Shahid Beheshti University of Medical Sciences (SBMU) in 2023, of whom 277 people were selected as a sample using the available sampling method. The Beck Scale for Suicidal Ideation (BSSI-1997), the Tehran Multidimensional Perfectionism Scale (TMPS-2007) and the Depression, Anxiety and Stress Scale (DASS-21-1995) were used to collect the data. Data was analyzed using structural equation modeling with SPSS and Amos software version 22. RESULTS: Out of 277 participants, 30% (N = 83) were male and 70% (N = 194) were female. The findings showed that the research model had goodness of fit. There was a significant relationship between perfectionism and psychological distress (ß = 0.76, P < 0/001) and between psychological distress and suicidal thoughts (ß = 0.66, P < 0/001). However, there was no direct relationship between perfectionism and suicidal ideation (P > 0.01), but perfectionism played a role in residents' suicidal ideation through psychological distress (ß = 0.50, P < 0/001). In other words, perfectionism led to suicidal ideation by increasing the psychological distress of the residents. In addition, perfectionism and psychological distress were able to explain 42% of the variances of suicidal ideation (R2 = 0/42). CONCLUSION: The results highlighted the crucial role of psychological distress in suicidal ideation of medical residents. Accordingly, substantial support from health-sector managers and policymakers is essential to meet the requirements of medical residents.

Optimizing modern surgical simulation through instructor feedback - insights from a retrospective observational study in a tertiary hospital.

BACKGROUND: Laparoscopic surgery is associated with a prolonged learning curve for emerging surgeons, and simulation-based training (SBT) has become increasingly prominent in this context due to stringent working time regulations and heightened concerns regarding patient safety. While SBT offers a safe and ethical learning environment, the accuracy of simulators in the context of evaluating surgical skills remains uncertain. This study aims to assess the precision of a laparoscopic simulator with regard to evaluating surgical performance and to identify the instructor's role in SBT. MATERIALS AND METHODS: This retrospective study focused on surgical residents in their 1st through 5th years at the Department of Surgery of Linkou Chang Gung Memorial Hospital. The residents participated in a specially designed SBT program using the LapSim laparoscopic simulator. Following the training session, each resident was required to perform a laparoscopic procedure and received individualized feedback from an instructor. Both simulator and instructor evaluated trainees' performance on the LapSim, focusing on identifying correlations between the simulator's metrics and traditional assessments. RESULTS: Senior residents (n = 15), who employed more complex laparoscopic procedures, exhibited more significant improvements after receiving instructor feedback than did junior residents (n = 17). Notably, a stronger correlation between the simulator and instructor assessments was observed in the junior group (junior Global Operative Assessment of Laparoscopic Skills (GOALS) adjusted R2 = 0.285, p = 0.016), while no such correlations were observed among the senior group. CONCLUSION: A well-designed, step-by-step SBT can be a valuable tool in laparoscopic surgical training. LapSim simulator has demonstrated its potential in assessing surgical performances during the early stages of surgical training. However, instructors must provide intuitive feedback to ensure appropriate learning in later stages.

Graduated responsibility and competency-based education in pathology residency programs: a five-year semi-longitudinal landscape assessment on autonomy and supervision.

Pathology residency training has been criticized for having too little opportunities for resident autonomy. As graduate medical education moves to competency-based models measuring competency and giving autonomy for specific tasks will be important. To determine how much autonomy residents are currently granted we surveyed pathology residency directors with regard to a list of usual pathology tasks and compared responses with those of a similar survey from 2018. Among the 29 programs whose directors responded, we found a considerable range within which some programs give much autonomy and others very little. Most programs did not describe measuring competency before granting performance of specific activities. We urge that restrictive programs examine the more permissive programs to see how they can move toward granting more autonomy.

Which obstetrics-gynecology residency programs are training future reproductive endocrinology and infertility fellows? An observational study.

Objective: To identify where reproductive endocrinology and infertility (REI) fellows trained for residency. Design: Observational, cross-sectional study. Setting: Not applicable. Subjects: Reproductive endocrinology and infertility fellows. Interventions: Not applicable. Main Outcome Measures: Percentage of fellows who completed residency training at an institution with an REI fellowship program. Results: A total of 289 fellows were identified among the graduating fellowship classes from 2023-2027. Of those fellows, 69.9% completed residency at an institution that had an associated REI fellowship program, and 19.7% remained at the same institution for residency and fellowship. In the last 5 years, 34.4% of obstetrics and gynecology residency programs have had at least 1 resident enter REI fellowship. Conclusions: Most matriculated REI fellow physicians train at residency programs that have an associated REI fellowship program.

Gender Differences in Self-Description: A Linguistic Analysis of Orthopedic Surgery Residency Application Personal Statements.

OBJECTIVE: The purpose of this study is to assess differences in language characteristics in personal statements written by male and female applicants to an orthopedic surgery residency program. DESIGN: This is a blinded retrospective analysis of personal statements from all applicants to an orthopedic surgery residency training program during 1 application cycle. Language characteristics were analyzed using a linguistic analysis software. This software evaluated 19 variables, including word count, 4 summary language variables (analytical thinking, clout, authenticity, and emotional tone), and 14 additional word categories. SETTING: Our study took place at [institution]. PARTICIPANTS: All applications submitted during the 2018-2019 residency application cycle were analyzed. 889 applicants were included in the study based on exclusion criteria, which omitted the 5 applicants who ultimately matched at our institution, as well as non-US citizens. RESULTS: Word count was not statistically significant between groups. Amongst the summary language variables, authenticity was higher in female applicants (p = 0.0142). Of the selected word categories, males averaged a higher score in certainty (p = 0.0418), while females averaged higher scores in curiosity (p = 0.0102), perception (p = 0.0486), and attention (p = 0.0293). CONCLUSIONS: Subtle differences exist in the language characteristics of personal statements written by male and female applicants to orthopedic surgery residency. The implications of our findings would be strengthened by new data on specific language characteristics and communication skills most desired by orthopedic program directors. Lastly, as evaluation metrics for residency applications continue to change, personal statements may assume an even more important role.

Laparoscopic Radical Prostatectomy: Assessing the Impact of Residency Training on Early Surgical Experience.

BACKGROUND: Transferring the intricate laparoscopic radical prostatectomy (LRP) technique poses a considerable challenge for novice surgeons. Fellowship programs, typically lasting three to twelve months, remain the primary avenue for acquiring laparoscopic skills. This study proposes that residency-based laparoscopy training confers distinct advantages over fellowship programs during the initial stages of LRP. METHODS: The study analyzed retrospectively collected data and operation videos from the first and second sets of fifty operations (Group 1 and Group 2) out of a total of 553 performed by the "fellow" surgeon between August 2009 and December 2022, and the first fifty operations by the "resident" surgeon from January 2022 to June 2023. Parameters examined included patient demographics, preoperative prostate-specific antigen (PSA) levels, grades, stages, operation durations, complications, postoperative outcomes, and short-term (6-month) oncological and functional results. RESULTS: No statistically significant differences were observed in prostate volume, age, body mass index, or PSA levels between Groups 2 and 3 or 1 and 3 (p > 0.05). Nevertheless, Group 3 exhibited significantly more International Society of Urological Pathology grade 3 and 4 cases than Group 1 (p = 0.004) and Group 2 (p = 0.006). Additionally, Group 3 had a shorter anastomosis time (AT) (25 min vs. 35 min, p < 0.001) and reduced estimated blood loss (EBL) (275 mL vs. 385 mL, p = 0.008) compared to Group 1. No significant differences were found among the groups regarding intraoperative complications, nerve sparing, or lymph node dissection rates. While Group 2's anastomosis time was comparable to that of Group 3 (24 min vs. 25 min, p = 0.144), it demonstrated a significantly shorter insufflation duration (150 min vs. 170 min, p < 0.001). Functional outcomes, including continence and erectile function at six months, showed no significant differences across the groups. CONCLUSIONS: This study underscores the potential benefits of integrating LRP training into a surgeon's residency, particularly in the early stages of their learning curve (LC), by reducing anastomosis and operation times and EBL in the first fifty cases. Initial findings suggest that implementing modular training in residency programs could enhance LRP proficiency, benefiting both surgeons and patients.

Assessing vaccine hesitancy among healthcare providers in Brazil: the influence of vaccine status and professional experience.

OBJECTIVE: Assess the occurrence of vaccine hesitancy among pediatricians and their patients and identify potential predictors to mitigate hesitancy among them. METHODS: The study is a cross-sectional survey using an online questionnaire sent to pediatricians affiliated with the Brazilian Society of Pediatrics. The data was analyzed using statistical methods such as exploratory factor analysis, principal component analysis, correspondence analysis, and generalized linear mixed models. RESULTS: A total of 982 respondents, with a majority being females (77.4%), participated in the research. Among them, the proportion of pediatricians with complete vaccine status was 41.14%, while 90.6% had undergone medical residency. Furthermore, 9.3% worked in public healthcare settings, 30.4% in private settings, and 60.3% in mixed healthcare settings. The analysis revealed a significant association between vaccine status and pediatricians' misconceptions about COVID-19 vaccines, with those having complete vaccine status showing lower misconceptions (mean difference of -0.15, p = 0.010). Moreover, pediatricians with medical residency experience exhibited fewer misconceptions about COVID-19 vaccines (mean difference of -0.33, p = 0.002). Additionally, correspondence analysis unveiled the presence of two distinct profiles among pediatricians, showcasing variations in vaccine education, professional experience, and vaccine confidence perceptions. CONCLUSION: The study highlights the influence of vaccine status and medical residency experience on pediatricians' attitudes and misconceptions about vaccines, emphasizing the need for targeted educational interventions to promote vaccine confidence and combat hesitancy within the healthcare provider community.

AAPM BTSC Report 377.B: Physicist brachytherapy training in 2022 - A survey of therapeutic medical physics residents.

BACKGROUND: A survey of medical physics residency program directors was conducted in Spring 2021 to examine the current state of brachytherapy (BT) training during residency. In this related work, a subsequent survey of therapeutic medical physics residents in 2022 was conducted to assess the confidence and experience of the trainees. Concerns for access to high-quality and diverse training in BT have escalated in importance due to recent declines in BT utilization. METHODS: A survey consisting of 26 questions was designed by a working unit of the Brachytherapy Subcommittee of the American Association of Physicists in Medicine (AAPM) and approved for distribution by the Executive Committee of the AAPM. The survey was distributed to current trainees and recent graduates of the Commission on Accreditation of Medical Physics Education Programs accredited therapeutic medical physics residency programs by the AAPM. The participant response was anonymously recorded in an online platform and subsequently analyzed using spreadsheet software. RESULTS: The survey was distributed to 796 current medical physics residents or recent graduates over the course of 6 weeks in February and March of 2022. The survey received 736 views and a total of 182 responses were collected, with 165 respondents completing the survey in full. Among those responses, 110 had completed their residency training, with program start dates ranging from calendar years 2015 to 2021. Individual responses from the survey takers (including partial survey submissions) were evaluated and analyzed to compile results. CONCLUSIONS: Medical physics residents reported the highest levels of confidence and caseload for gynecological BT procedures when compared with other surveyed treatment techniques. This indicates opportunities to improve training and increase access to clinical caseload are needed in order to improve competency and confidence. Time constraints (clinical and rotation-based) were indicated as impediments to BT proficiency. Medical physics residents reported enthusiasm for additional training opportunities in BT, and it is evident that additional structure and programs are required to ensure adequate access to BT training during residency.

Influential Factors in the Selection of Subspecialty Fellowship Training Among Surgical Trainees in Oman.

Objectives: Surgical training has evolved over the past few decades, with an increasing number of surgeons pursuing subspecialty training through fellowship programs across various surgical specialties. While published reports confirm this trend, few studies explored the factors that determine which fellowship training surgical residents would pursue. This cross-sectional study aims to investigate the factors influencing fellowship choices made by surgical trainees in Oman. Methods: An online questionnaire, developed based on previously validated instruments, included 14 factors considered crucial for choosing a future career. Statistical analysis was performed to determine item-level validity, scale-level validity, and reliability. The survey was distributed via email and closed after six weeks for data analysis. Results: The survey achieved a response rate of 60.9%. The analysis revealed that the most influential factor among surveyed surgeons in selecting a subspecialty was prestige, with an average score of 2.7. The least reported influential factors were variety of cases (average score of 1.8) and personal interest (average score of 1.4). Only 57.7% of respondents received career choice guidance. Conclusions: Factors influencing the choice of surgical subspecialties vary among the different groups. This information can be valuable in designing programs and structuring professional career guidance and counseling.

Geographical Distribution of Osteopathic Neurosurgery Residents.

INTRODUCTION: The neurosurgery residency match has grown increasingly competitive, especially for osteopathic (DO) medical students, amidst the transition to a single accreditation system in 2020. This shift required former American Osteopathic Association (AOA) programs to apply for Accreditation Council for Graduate Medical Education (ACGME) accreditation, leading to a notable reduction in programs with a history of accepting DO applicants. This study aims to explore both potential geographical trends in residency match among recent DO neurosurgical residents and in the number of DO neurosurgical residents pre- and post-ACGME merger. METHODS: Neurosurgery residency programs during the 2023-2024 academic year were identified, and each program's residents, resident degrees, and resident post-graduate years were collected from residency programs' websites. Descriptive statistics were used to analyze the ratios of DO and allopathic (MD) residents, while regression analyses were used to determine the trends in DO residents between 2017 and 2024. DO residents were also collated by state to observe their geographical distribution. RESULTS: A comprehensive cross-sectional analysis of 115 neurosurgery residency programs across the United States from 2016 to 2024 reveals a significant decrease in DO residents, from 14 in 2016 to four in 2024, with an average of six DO residents per year post-merger. A geographical heatmap analysis pinpointed New Jersey, Michigan, and California as states with the highest proportions and numbers of DO neurosurgery residents. CONCLUSION: These findings show the geographical distribution of DO neurosurgery residents in the US. Recognizing and understanding these geographical trends could be essential in the strategic application planning for DO candidates and the need for residency programs to reassess selection criteria to be more inclusive of DO applicants.

Ethical Approaches in General Surgery Residency Training: A Blended Learning Module Trial.

AIM: This study aimed to develop a blended training module focusing on ethical approaches within general surgery residency training and to assess the impact of this training on participants. METHODS: Based on the literature review and input from both general surgery residents and trainers, 14 topics were identified, and corresponding learning objectives were formulated. The training was conducted through a blended learning module, which encompassed online video presentations alongside face-to-face sessions involving real-life cases. Assessment of the training involved administering test-formatted exams both before and after the training, which assessed the learning objectives of the 14 topics. These exams comprised multiple-choice questions and true/false inquiries based on case-based propositions. Additionally, feedback regarding the training was solicited from the residents. RESULTS: The study involved 20 general surgery residents. Assessment revealed a statistically significant increase in exam success among the residents after the training (p<0.001). Additionally, feedback indicated that the training model was effective. CONCLUSIONS: Developing a blended learning module that combines online and face-to-face education, supplemented with real-life case studies, and incorporating discussions on ethical dilemmas during face-to-face sessions, along with assessment through exams, will significantly enhance the proficiency of residents in surgical ethics.

Navigating the Discrepancy: How Cost of Living (COL) Adjustments Impact Otolaryngology Residents' Salaries.

OBJECTIVE: To compare differences in otolaryngology residents' salaries in different cities and states before and after adjusting for the cost of living. STUDY DESIGN: Cross-sectional analysis. SETTING: Accreditation Council for Graduate Medical Education (ACGME) otolaryngology residency program websites. METHODS: US otolaryngology residency programs were identified via the ACGME database in December 2023. Stipends posted by each residency program were compared to the cost of living (COL) for related states and major cities. A baseline value of 100 was used as the mean COL, values over 100 indicate above-mean COL. The weighted salary by state and cities for postgraduate year (PGY) 1 to 5 combined was expressed as mean (SD). Comparisons between salaries before and after adjustment for the COL were assessed using t tests. RESULTS: The mean otolaryngology residency stipend across the nation, by city, was $70,572 (n = 1290, range: $58,100-$93,402; SD = $8370), with a post-COL adjustment mean stipend of $64,055 (range: $39,193-$76,674, SD = $10,094, p < .001). Otolaryngology residents in Manhattan, New York State faced a mean decrease from $89,282 to $39,193 (-56%) post-COL adjustments. Following that were Boston and Los Angeles programs which saw a -$26,402 (-32%) and -$24,761 (-32%) mean decrease after COL adjustments, respectively. CONCLUSION: Otolaryngology residents in high-cost areas experience significant salary reductions because of COL adjustments, resulting in financial strain. Residents in such regions endure increased financial pressure compared to those in low-cost areas, as current salaries fail to align with living expenses.

Beyond Morbidity and Mortality Conference: How Do We Learn From Special Cases?

OBJECTIVE: Physicians experience scary cases in the course of usual medical practice. Cases of near misses, legal and ethical dilemmas, or unique clinical challenges are great sources of education. However, there is no format for presentation and dissemination of cases that do not meet criteria for morbidity and mortality (M&M) conferences. The Scary Cases Conference is an innovative educational forum for scrutiny and analysis of these challenging clinical cases. Scary Cases differs from traditional Morbidity and Mortality conferences as it explores outcomes beyond the scope of medical or surgical errors. METHODS: From 2011 to 2021: 11 regional and 10 national "Otolaryngology Scary Cases" conferences and mini-seminars were held. The cases presented were analyzed for case specialty, area of management deemed troublesome, and compared to M&M conference criteria. RESULTS: 187 cases were presented. 62% percent of cases included traditional medical problems, whereas 21% involved legal issues, and 17% focused on ethical dilemmas. For the cases with medical problems, 31% involved airway obstruction, 17% nerve injuries, and 17% malignancy. 49% of cases would have met criteria for presentation at traditional M&M conferences. Of all the "scary cases," 25% were near misses and 26% represented ethical or legal dilemmas which would not be classified as morbitidy, mortality, or near miss. CONCLUSIONS: The Scary Cases provides a forum conducive to learning amongst peers and experts. It allows medical and surgical specialties to share the cases deemed most impactful. The M&M conference would only include half of such cases, but could be expanded beyond the traditional scope in the future.

Not From Around Here: Evaluation of In-Person Interviews in an Urban General Surgery Residency Program.

OBJECTIVE: This study used a program evaluation approach to investigate the perceptions of utilizing in-person applicant interviews for a general surgery residency program. DESIGN: The study utilized de-identified data routinely collected during the residency program applicant interviews in the General Surgery Residency Program during the fall of 2023. Applicant and faculty/resident exit interview questionnaires were developed to evaluate perceptions of in-person interviewing; the questions were informed by domains for considering the appropriateness and feasibility of continuing in-person interviews as identified by the institution's Graduate Medical Education Committee. Applicants completed the survey at the end of their interview day; faculty and resident interviewers completed the survey following the applicant rank meeting. SETTING: The Sponsoring Institution approved a pilot transition from virtual to in-person interviews for the General Surgery Residency Program 2023 recruitment cycle. Surveys were completed electronically. PARTICIPANTS: Sixty-four applicants were interviewed and requested to complete the exit survey. The survey was completed by 55 (Response rate = 86%) program applicants and eight (Response rate = 100%) faculty and residents in the program. RESULTS: 49.1% of applicants indicated a preference for in-person interviews, 40.0% of applicants indicated a preference to choose and only 10.9% indicated a preference for virtual interviews. Applicants from out-of-state had a significantly higher preference for in-person interviews than those from in-state. Applicants and faculty interviewers perceived in-person interviews to provide a strong assessment of applicants. Applicants from out-of-state had a significantly higher confidence in their ability to demonstrate their strength and assess fit than those from in-state. CONCLUSIONS: While most applicants and faculty interviewers were generally comfortable with an in-person interviewing format, applicants from out-of-state had a particularly high preference for and perception of in-person interviews. General surgery residency programs and sponsoring institutions would benefit from the development of a comprehensive program evaluation strategies for their residency program interviews to make evidence-informed decisions about how best to structure interviews for their programs.

Self-Assessment and Coaching Techniques Utilized in an Intraoperative Resident Peer Coaching Program.

OBJECTIVES: To evaluate junior resident self-assessments and utilization of effective coaching principles by chief resident coaches in a resident peer surgical coaching program. DESIGN: All residents underwent the Surgical Coaching for Operative Performance Enhancement (SCOPE) coaching curriculum. Junior residents ("coachees") were paired with chief resident coaches. A case was selected for coaching. The coaching structure was: 1) junior resident preoperative goal setting, 2) unscrubbed, intraoperative case observation by the coach, 3) postoperative coaching debrief. Debriefs were recorded to determine frequency of junior resident self-assessment and use of the effective coaching principles (goal setting, collaborative analysis, constructive feedback, action planning). Deductive thematic analysis was conducted. SETTING: A general surgery residency at a single, large academic medical center. PARTICIPANTS: 16 junior resident (PGY1-3) coachees and 6 chief resident (PGY5) coaches. RESULTS: There were 18 recorded coaching debrief sessions that lasted an average of 12.65 minutes (range 4-31 minutes). All debrief sessions included self-assessments by the junior resident coachees. There were numerous examples of the 4 effective coaching principles with all debriefs including use of at least 3. The most commonly used were collaborative analysis and constructive feedback. For technical skills, these highlighted body positioning, needle angles, and dissection techniques, including instrument choice, laparoscopic instrument technique, and use of electrocautery. Collaborative analysis of nontechnical skills emphasized communication with the attending surgeon, specifically operative decision-making and advocating for resident autonomy. Nontechnical constructive feedback addressed strategies the coaches themselves used for managing stress, interacting with attendings, and excelling in the operating room. CONCLUSIONS: Self-assessments and use of effective coaching principles were frequent throughout peer coaching debriefs. Collaborative analysis and constructive feedback were employed to promote operative technical and nontechnical skill development. Within a peer coaching program, residents are able to employ high level teaching and coaching techniques to encourage operative performance enhancement.