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MIS training in Canada: a national survey of general surgery residents

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Abstract

Background

General surgery trainees’ perceptions regarding their own laparoscopic training remain poorly defined. The objective of this survey was to identify and evaluate learner experiences with laparoscopic procedures in general surgery programs on a national level.

Methods

Two hundred eighty-four residents were identified and contacted at English-speaking general surgery programs across Canada. Each was asked to complete a web- or paper-based survey regarding their demographics, experiences with basic and advanced minimally invasive surgery (MIS) procedures, and perceived barriers to training.

Results

Two hundred fifty-two of 284 (89%) surveyed residents responded. Eighty-seven percent of the residents had access to a skills lab that taught MIS techniques; however, standardized MIS curricula were implemented 53% of the time. Eighty percent of residents felt that skills lab training translated to improved performance in the OR. Although 90% of residents felt that they would be comfortable performing basic laparoscopic procedures, only 8% stated they would be comfortable performing advanced procedures at the end of their training. Moreover, 90% of general surgery residents felt that it was the academic surgical department’s responsibility to teach both basic and advanced procedures, and 35% of respondents felt their surgical program was meeting this requirement. Half of the residents felt they had limited opportunity to be a primary surgeon because an MIS fellow was present.

Conclusions

There exists a wide disparity between the expectations of residents and their actual experience. The majority of residents are concerned that they will not acquire sufficient laparoscopic skills during their training to perform advanced cases in practice. Additionally, the balance between resident and fellow-level cases needs to be more clearly defined as the majority of respondents identified the presence of a MIS fellow as a negative learning influence. Finally, although most centers had a surgical skills lab, 47% of respondents felt that the curriculum was not standardized and this also needs to be addressed.

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Disclosures

Alia Qureshi, Ashley Vergis, Carolina Jimenez, Jessica Green, Aurora Pryor, Christopher M. Schlachta, and Allan Okrainec have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of General Surgery, University of Toronto, Toronto, ON, Canada

    Alia Qureshi & Allan Okrainec

  2. Division of General Surgery, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, ON, M8Y 1E8, Canada

    Ashley Vergis, Carolina Jimenez, Jessica Green & Allan Okrainec

  3. Section of General Surgery, University of Manitoba, Winnipeg, MB, Canada

    Ashley Vergis

  4. Duke University Medical Center, Durham, NC, USA

    Aurora Pryor

  5. Departments of Surgery and Oncology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada

    Christopher M. Schlachta

  6. Canadian Surgical Technology & Advanced Robotics (CSTAR), University Hospital, London Health Sciences Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada

    Christopher M. Schlachta

  7. Toronto Western Hospital, University Health Network, Main Pavilion, 8-322, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada

    Allan Okrainec

Authors
  1. Alia Qureshi
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  2. Ashley Vergis
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  3. Carolina Jimenez
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  4. Jessica Green
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  5. Aurora Pryor
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  6. Christopher M. Schlachta
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  7. Allan Okrainec
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Corresponding author

Correspondence to Allan Okrainec.

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Qureshi, A., Vergis, A., Jimenez, C. et al. MIS training in Canada: a national survey of general surgery residents. Surg Endosc 25, 3057–3065 (2011). https://doi.org/10.1007/s00464-011-1670-9

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  • DOI: https://doi.org/10.1007/s00464-011-1670-9

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