We Are What We Write: 133 Years of History in 4 Surgical Journals.

The profession of surgery has long purported to value its history. This study evaluates that interest by calculating the percent of historical articles in 4 major general surgery journals from 1885 to 2018 (Annals of Surgery; Surgery, Gynecology, and Obstetrics; American Journal of Surgery; and Archives of Surgery). Of all articles published over the last 133 years, 1.65% focused on history, although this percentage fluctuated between 0% and 4.77%. A peak in the 1920s likely both represents and buttresses a national movement to elevate and professionalize the field of surgery. A plurality of the articles were biographical. The proportion of history articles in these journals has been declining of late due to reasons such as the proliferation of periodicals and impact factor considerations. The new Annals of Surgery-Open promises an ideal forum to publish this work, celebrate our heritage, and study the history of who we are as surgeons.

Survey of student education in surgery.

BACKGROUND: Few data exist comparing medical student surgical education programs across the US and Canada. We conducted a 30-question, Web-based survey of 142 medical schools in the US and Canada about the administration of undergraduate surgical education programs at their institutions. STUDY DESIGN: From October 2005 to January 2006, 142 Association of American Medical Colleges (AAMC) medical schools in the US and Canada were asked to complete a 30-item, Web-based questionnaire. Descriptive statistics were compiled for all responses and data were analyzed using Student's t-test. RESULTS: One hundred two medical schools responded to the survey (90 of 125 US and 12 of 17 Canadian schools, overall response rate,=72%). The majority of surgical clerkships have between 16 and 30 students rotating at a time through 2 to 4 teaching sites. The most frequent overall clerkship duration was 8 weeks, divided most frequently between a 4- to 6-week general surgery rotation and a 4-week subspecialty rotation. There was no consensus about what services constitute general surgery rotations, although the most common subspecialty rotations were urology (68%) and orthopaedics (66%). American medical schools were more likely to use the National Board of Medical Examiners (NBME) subject examination for student assessment (90.9% US versus 50.0% Canadian, p < 0.05); Canadian medical schools were more likely to use an Objective Structured Clinical Examination (69.2% Canadian versus 37.7% US, p < 0.05) and other written examinations (69.2% Canadian versus 37.7% US, p < 0.05). CONCLUSIONS: There is wide variation in the structure and administration of medical student surgical education programs in the US and Canada. These findings underscore the need for a clerkship directors committee and a national dialog about a core student curriculum to ensure consistency in the quality of student education in surgery.

William Osler and appendicitis.

William Osler had cared for patients with 'typhlitis' and had seen perforations of the appendix in postmortem examinations before the day when he heard Reginald Heber Fitz proclaim that typhlitis was in fact disease of the appendix, that early surgery was indicated to treat perforation and that the process ought to be called 'appendicitis'. This paper examines the evolution of Osler's thoughts about appendicitis and documents his changing recommendations for treatment as presented in the eight editions of his text published during his lifetime.