Journal of Surgical Education最新文献

{"title":"Changes in Matches into Surgical Residencies and Fellowships Following the ACGME Merger","authors":"Sara S. Soliman ,&nbsp;Gabrianna Andrews ,&nbsp;Salma Emara ,&nbsp;Naomi Watkins-Granville ,&nbsp;Alicia Podwójniak ,&nbsp;Iman Hasan ,&nbsp;Jha Stuti ,&nbsp;Alissa Brotman","doi":"10.1016/j.jsurg.2025.103466","DOIUrl":"10.1016/j.jsurg.2025.103466","url":null,"abstract":"<div><h3>Objective</h3><div>In 2015, a transition was initiated among the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA), and American Association of Colleges of Osteopathic Medicine (AACOM), resulting in a single accrediting body for residencies and fellowships as of 2020. This study aims to elucidate whether this had an impact on osteopathic students' matching into general surgery residencies, integrated surgery residencies, and surgical fellowships.</div></div><div><h3>Design, Setting, and Participants</h3><div>Using the Results and Data Residency Match data file and the Results and Data: Specialties Matching Service data from the National Resident Matching Program from 2015 to 2024, data was extracted regarding osteopathic and allopathic match rates into general surgery residency and surgical fellowships, respectively. Applicants were grouped on matching in 2015-2019 (premerger) or 2020-2024 (postmerger). Statistical analysis using the Chi-Square test was performed to determine if there was a significant difference in the mean number of matches in the pre and postmerger groups (p &lt; 0.05).</div></div><div><h3>Results</h3><div>Postmerger, the proportion of osteopathic students matching into general surgery residency increased significantly (DO, 5.77% vs 14.25%, p = 0.032). However, the proportion of osteopathic students who matched into integrated residencies, such as thoracic, plastic, and thoracic surgery, did not increase (p &gt; 0.05). For surgical fellowships, there was no significant increase in the proportion of osteopathic students matching (DO, 6.36% vs 9.59%, p = 0.389). Independently, an increase was seen in osteopathic matches across fellowships; however, it was only significant for vascular (8.16% vs 14.17%, p = 0.013) and hand surgery (3.79% vs 5.86%, p = 0.019).</div></div><div><h3>Conclusions</h3><div>Postmerger, there was an increase in osteopathic students and physicians filling general surgery residency, vascular, and hand surgery fellowship positions. However, the proportion of osteopathic students who matched into integrated surgery residencies remained the same.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103466"},"PeriodicalIF":2.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Behavioral and Neural Activity Changes During Laparoscopic and Robotic Surgery Trainings","authors":"Mehmet Emin Aksoy MD, PHD ,&nbsp;Kurtulus Izzetoglu PHD ,&nbsp;Nihat Zafer Utkan MD ,&nbsp;Atahan Agrali MS ,&nbsp;Serhat Ilgaz Yoner MS ,&nbsp;Ashley Bishop MS ,&nbsp;Patricia A. Shewokis PHD","doi":"10.1016/j.jsurg.2025.103486","DOIUrl":"10.1016/j.jsurg.2025.103486","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to compare the cognitive workload levels of general surgery residents by measuring prefrontal cortex hemodynamic activity while performing a similar task using robotic-assisted surgery (RAS) and laparoscopic surgery simulators.</div></div><div><h3>Design</h3><div>The study was conducted with 22 general surgery residents who completed a peg transfer task in simulated laparoscopic and RAS training environments. Participants' performance and neurophysiological data were collected over a 1-month period.</div></div><div><h3>Setting</h3><div>The study was conducted at Acibadem Mehmet Ali Aydinlar University- CASE (Center of Advanced Simulation and Education), utilizing a laparoscopic training simulator (CAE Lap VR) and robotic surgery simulator (Da Vinci Surgical System Si console with Backpack).</div></div><div><h3>Participants</h3><div>Twenty-two general surgery residents (mean [SD] age, 29.45 [2.40] years; 18 [81.82%] male) volunteered for the study. None of the participants had prior experience with RAS or RAS simulators, whereas most had varying degrees of laparoscopic surgery experience.</div></div><div><h3>Results</h3><div>Significant differences were observed between RAS and laparoscopic simulations in terms of performance time and neural activity. Peg transfer times were shorter in RAS simulations compared to laparoscopic simulations (χ2(3) = 134.805, p &lt; 0.001). Mean oxygenated hemoglobin (ΔHbO) levels in the prefrontal cortex were lower in RAS simulations (χ2(3) = 20.695, p &lt; 0.001), indicating reduced cognitive workload. Relative Neural Efficiency (RNE) and Relative Neural Involvement (RNI) scores were higher in RAS tasks (χ2(1) = 55.765, p &lt; 0.001), suggesting greater efficiency and involvement during robotic-assisted procedures.</div></div><div><h3>Conclusions</h3><div>The findings indicate that RAS tasks are associated with lower cognitive workload and improved efficiency compared to laparoscopic tasks. Incorporating neural indices alongside performance metrics may enhance training assessments and provide deeper insights into trainees’ experiences in simulation-based surgical education.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103486"},"PeriodicalIF":2.6,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Should Laparoscopic Surgery Training be Planned in a Resource-Limited Environment?","authors":"Huseyin Kilavuz MD ,&nbsp;Abdirahman Burale Ahmed MD ,&nbsp;Abdinasir Mohamed Mohamud MD ,&nbsp;Badri Omer MD ,&nbsp;Fikret Ezberci MD ,&nbsp;Suleyman Salman MD ,&nbsp;Veli Mihmanlı MD ,&nbsp;Suat Turgut MD","doi":"10.1016/j.jsurg.2025.103483","DOIUrl":"10.1016/j.jsurg.2025.103483","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Laparoscopic surgeries (LSs) are underperformed in low-income countries with inadequate health infrastructure due to many restrictive factors. In this study, we aimed to present the process and results of the first bilateral collaboration protocol (BCP) for LS in an African university hospital where laparoscopic surgery had not been performed before.</div></div><div><h3>DESIGN</h3><div>A 3-stage BCP was implemented between the University of Health Sciences (Turkey) and Jigjiga University Hospital (Somali State, Ethiopia) between January and June 2024. In the first stage, training was received in Turkey for 3-6 months. In the second stage, 2 general surgery, 2 gynecology and obstetrics, and one ear-nose-throat (ENT) clinic training officers from the University of Health Sciences went to Jigjiga University Hospital and provided the installation of laparoscopic devices, on-site training of surgeons and other operating room personnel, and the initiation of the first laparoscopic and minimally invasive surgeries for a week. In the third stage, LS performed in the first 30 days after the end of the program were connected via video call.</div></div><div><h3>SETTING</h3><div>This training was held at Jigjiga University Hospital, the only university hospital in the Somali state of Ethiopia.</div></div><div><h3>PARTICIPANTS</h3><div>The first stage of this training was attended by the teaching staff of the surgical clinics at Jigjiga University Hospital. The second stage of the program was attended by all surgeons, clinical assistants, operating room nurses and staff at Jigjiga University Hospital.</div></div><div><h3>RESULTS</h3><div>In the second stage of the program, a total of 25 patients underwent the first laparoscopic and minimally invasive surgeries in the state in 1 week. 13 (52%) were performed by general surgery, 7 (28%) by gynecology and 5 (20%) by ENT. In the third stage, 24 laparoscopic procedures were performed in the first 30 days.</div></div><div><h3>CONCLUSIONS</h3><div>In low-income countries with limited resources, laparoscopic surgeries can be introduced with the right training programs and appropriate bilateral collaboration programs.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103483"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural General Surgeons’ Perspectives Regarding the Provision of Surgical Care to Children","authors":"Gopika SenthilKumar PhD ,&nbsp;Katherine T. Flynn-O'Brien MD MPH FACS ,&nbsp;Mary Fallat MD FACS ,&nbsp;Kyle J. Van Arendonk MD PhD FACS","doi":"10.1016/j.jsurg.2025.103471","DOIUrl":"10.1016/j.jsurg.2025.103471","url":null,"abstract":"<div><h3>Objective</h3><div>The volume of surgical care provided to children by general surgeons has decreased over time, which disproportionally impacts rural children. This study aimed to understand factors that influence rural general surgeons’ decisions regarding provision of surgical care to children.</div></div><div><h3>Design</h3><div>Cross-sectional survey of 55 items conducted between February 2023 and March 2024</div></div><div><h3>Setting</h3><div>Survey distributed at meetings, ACS communities, social media.</div></div><div><h3>Participants</h3><div>162 nonpediatric surgery trained general surgeons practicing in rural communities across North America.</div></div><div><h3>Results</h3><div>Among respondents, median age was 58 years, and 75.9% identified as male and 87.7% as White/Caucasian. While a majority of respondents operated on children, most performed &lt; 20 surgeries per year. Factors reported by surgeons to be most influential regarding their decision to operate on children were personal experience/expertise/training. Availability of a pediatric inpatient unit and proximity to a children's hospital/pediatric surgeons were the next most influential factors. The amount of pediatric surgery exposure during training, feeling this training was adequate, and a greater number of years in practice since completion of training all significantly correlated with comfort in operating on younger patients. The amount of pediatric surgery exposure during training also correlated with the number of surgeries performed per year in children. &gt; 90% of respondents reported that they would have completed additional training in pediatric surgery if it had been available during or after completion of residency. About 3 to 6 months was reported by most respondents as the optimal duration of additional pediatric surgery exposure.</div></div><div><h3>Conclusions</h3><div>New training paradigms that increase exposure to pediatric surgery during residency may facilitate rural surgeons’ provision of routine surgical care to children and minimize the travel burden currently experienced by rural children who require surgical care.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103471"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training and Assessment of Nontechnical Skills in Cardiothoracic Surgery: Current Literature Review","authors":"Chinedu C. Okoli MBBS, MSc ,&nbsp;Obieze C. Nwanna-Nzewunwa MBBS, MS ,&nbsp;Scott Buchanan MD","doi":"10.1016/j.jsurg.2025.103480","DOIUrl":"10.1016/j.jsurg.2025.103480","url":null,"abstract":"<div><h3>Background</h3><div>This review explores the surgical and psychological literature on cardiothoracic (CT) surgeons’ intraoperative nontechnical skills (NTS). Successful task performance depends on the seamless integration of technical skills (TS) and NTS. This paper aims to identify the training and assessment modalities for NTS in cardiothoracic surgery (CTS).</div></div><div><h3>Methods</h3><div>PubMed, Cochrane Library, BioMed Central, Medline, EDINA BIOSIS, Web-of-Knowledge, PsychINFO, and ScienceDirect were searched through to December 2023. Additionally, a manual search of the referenced work of each included article and relevant reviews in PubMed were performed to avoid missing any important data. Original research articles were included if they described NTS training modalities and their assessment in cardiac or thoracic surgeries. Exclusion criteria included any study without full-text availability, non–peer-reviewed publications, studies without extractable data, and duplicates. Retrieved articles were screened, and data extracted in duplicate by 2 independent reviewers.</div></div><div><h3>Results</h3><div>The literature search found 371 relevant references related to cardiothoracic surgery, 17 articles were included in this literature review, and 12 training tools were identified.</div></div><div><h3>Conclusions</h3><div>This review demonstrates the need for additional work to create reliable training and assessment methods for NTS in CTS.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103480"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Mini-CEX Evaluation Combined With Segmented Teaching Approach in the Training of Surgical Clinical Practice Skills for Resident Physicians","authors":"Chao Liu MMed ,&nbsp;Mei Ren MMed ,&nbsp;Chaoen Luo MMed ,&nbsp;Khan Asfandyar MMed ,&nbsp;Jia Liu MMed ,&nbsp;Dan Chen MD ,&nbsp;Zhengwen Lei MD","doi":"10.1016/j.jsurg.2025.103497","DOIUrl":"10.1016/j.jsurg.2025.103497","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of integrating Mini-CEX assessment with Segmented teaching on the improvement of surgical clinical practice skills among first-year resident physicians, and to compare its effectiveness with traditional teaching methods.</div></div><div><h3>Methods</h3><div>A total of 42 first-year resident physicians undergoing standardized training at the First Affiliated Hospital of Hengyang Medical School, University of South China from April to June 2024, who were participating in surgical clinical practice skills training for excision of superficial tumors, were selected as subjects. The participants were randomly divided into 2 groups: an experimental group and a control group, with 21 participants in each. The control group employed traditional teaching methods, while the experimental group utilized the Mini-CEX assessment combined with Segmented teaching methods. Both groups were assessed on their practical skills, theoretical knowledge, Mini-CEX evaluations, and Student Evaluation of Educational Quality (SEEQ) before and after the training, and their results were compared.</div></div><div><h3>Results</h3><div>There were no statistically significant differences in practical skills and theoretical knowledge scores between the experimental and control groups before training (p &lt; 0.05). However, after the training, the experimental group scored significantly higher than the control group in theoretical and practical exams, Mini-CEX evaluation dimensions, and SEEQ teaching quality assessment scores, with statistically significant differences (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The combination of Mini-CEX assessment with Segmented teaching methods can achieve better training outcomes in surgical clinical practice skills training.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103497"},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Dedicated Research Year on Applicant Familiarity in the Integrated Plastic Surgery Match","authors":"Oluwaseun D. Adebagbo BS ,&nbsp;Amanda Girardi BA ,&nbsp;Helen S. Quinn MD ,&nbsp;Lifei Guo MD, PhD, FACS","doi":"10.1016/j.jsurg.2025.103478","DOIUrl":"10.1016/j.jsurg.2025.103478","url":null,"abstract":"<div><h3>Objective</h3><div>“Applicant familiarity,” or prior knowledge of an applicant, is associated with successful plastic surgery match outcomes. While a research year (RY) enhances academic productivity, mentorship, and specialty exposure, its impact on familiarity and matching at the RY institution remains unclear. This study examines whether a RY improves applicant familiarity and match outcomes at the RY program.</div></div><div><h3>Design</h3><div>The Plastic Surgery (PRS) Match 2023 to 2024 Google spreadsheet was used to analyze matched applicants' RY status, familiarity with their matched program and match rates. Applicant familiarity included home program, research-year match (RYM), away/subinternship (SI) match, or unfamiliar program. Match rates between RY and non-RY applicants were compared using Chi-squared test.</div></div><div><h3>Setting</h3><div>N/A</div></div><div><h3>Participants</h3><div>213 applicants matched and 146 matched applicants with complete data were included.</div></div><div><h3>Results</h3><div>Among the matched PRS applicants, 71.9% had a home PRS program, and 50% completed a RY. Away/subinternship and home match rates for the entire matched cohort were 52.1% and 23.97%, respectively. Compared to the non-RY group, RY applicants had lower away/subinternship match rates (36.3% vs. 15.8%, respectively) and were significantly more likely to match at unfamiliar programs (0.68% vs. 18.5%, p &lt; 0.0001). Only 4.8% of RY applicants matched at their RY institution.</div></div><div><h3>Conclusions</h3><div>Most matched RY applicants secured positions at unfamiliar programs, with fewer than 5% matching at their RY institution. A dedicated RY provides limited benefit in fostering applicant familiarity for matching at a specific program, especially when compared to the higher match rates of away rotations and home programs.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103478"},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who is the “Ideal Surgical Trainee?”: A Qualitative Analysis of Letters of Recommendation to Subspecialty Surgical Fellowship","authors":"Jonathan S. Abelson MD, MS ,&nbsp;Ali Al Jabri MD ,&nbsp;Hina Bhat MD ,&nbsp;Elizabeth M. Breen MD ,&nbsp;Angela H. Kuhnen MD ,&nbsp;Sharon L. Stein MD ,&nbsp;Emily Steinhagen MD ,&nbsp;Julia T. Saraidaridis MD, MMSc","doi":"10.1016/j.jsurg.2025.103479","DOIUrl":"10.1016/j.jsurg.2025.103479","url":null,"abstract":"<div><h3>Objective</h3><div>It is unknown what traits practicing surgeons value in those wishing to become colorectal surgeons. The objective of this study was determine the most common qualities used to describe applicants to colorectal surgery residency.</div></div><div><h3>Design</h3><div>Letters of a recommendation (LOR) qualitatively analyzed to determine how writers described applicants. Letters were analyzed, coded, and categorized to understand the qualities most admired and devalued by reviewers.</div></div><div><h3>Setting</h3><div>LOR submitted to Lahey Hospital and Medical Center in Massachusetts</div></div><div><h3>Participants</h3><div>111 applicants to colorectal surgery residency at Lahey during the 2019 to 2020 cycle including 658 letters and 409 letter writers. There were 315 standardized LOR and 343 narrative LOR.</div></div><div><h3>Results</h3><div>75% of letters described some aspect of “grindstone” or hard-working attributes as being a positive. Other LORs valued attributes including being likeable and having good clinical and technical skills. The most frequent applicant flaws identified in the LOR included poor leadership skills and lack of delegation skills. Several letter writers also expressed concerns when an applicant was too soft spoken.</div></div><div><h3>Conclusions</h3><div>This study codifies the qualities valued by letter writers in describing colorectal surgery applicants. The descriptors used by surgeons in LOR can be thought of as a portrayal of the qualities composing an “ideal surgical trainee.” This cohort of LOR emphasized grindstone characteristics as a positive and poor leadership as a negative. As work-life integration becomes increasingly important to early career surgeons, intergenerational conflict may arise if the qualities lauded in the “ideal applicant” focus on work at all cost.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103479"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penny Wise, Pound Foolish: The Troubling Parallels of Corporatization in the Aviation Industry and Academic Surgery","authors":"Joshua Roshal MD ,&nbsp;Alec Max Bernard MD ,&nbsp;Tejas Sathe MD ,&nbsp;Jed Calata MD","doi":"10.1016/j.jsurg.2025.103468","DOIUrl":"10.1016/j.jsurg.2025.103468","url":null,"abstract":"<div><div>The passengers of Lion Air Flight 610 and Ethiopian Airways Flight 302 paid the ultimate price for decades of prioritizing profits over technical expertise at The Boeing Company. Now, American surgical education is showing similar signs of turbulence. While surgical training has long been known for its rigor and potency, corporatized medicine is compromising what was once a proud standard. The American Board of Surgery has recently overhauled graduation requirements from surgical residency, hoping to increase the trustworthiness of new surgeons to the public. However, we are at a tipping point where the decisions being made in hospitals mirror those that led to aviation failures. This is more than a professional issue; it's a public one. How we train the next generation of surgeons will determine the quality-of-care millions of people receive. This story is about systemic cracks—and how we can begin to repair them. Boeing's trajectory shifted from an engineering-first culture to a profit-driven one, and this shift has compromised safety and performance. Similarly, surgical education is undergoing a transformation driven by financial pressures. Hospitals are increasingly prioritizing revenue generation over the quality of training. The consequences? A lack of operative autonomy for residents, fewer opportunities for hands-on learning, and ultimately, a generation of surgeons less prepared for independent practice. Now surgeons are forced to meet productivity and “relative-value unit” demands that leave little time to train the next generation. While the field of surgery has initiated changes in surgical education from within, these efforts are not enough. We need funding and prioritization of educational endeavors. We aim to engage readers in this discussion because improving the quality of the next generation of surgeons is crucial to the quality of care they will receive. It's a conversation we need to have now—before the consequences become as visible as they have in the aviation industry.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103468"},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preference Signals and Away Rotations Greatly Influence Application Success in the Integrated Plastic Surgery Match","authors":"Jacob L. Kotlier BA ,&nbsp;Angela P. Mihalic MD ,&nbsp;Christopher Homsy MD","doi":"10.1016/j.jsurg.2025.103467","DOIUrl":"10.1016/j.jsurg.2025.103467","url":null,"abstract":"<div><h3>Objective</h3><div>Integrated plastic surgery implemented a preference signaling program (PSP) starting the 2022 to 2023 application cycle which allowed applicants to signal their top 5 preferred programs through the Plastic Surgery Central Application (PSCA). In this study, we aim to evaluate the effect on this new PSP at both the applicant and program level.</div></div><div><h3>Design</h3><div>This cross-sectional study relies on self-reported survey data from 2019 to 2024 from the Texas Seeking Transparency in Application to Residency (STAR) database. Variables associated were analyzed using 2-sided t-tests, Chi-squared tests, variance ratio testing and receiver operating characteristic (ROC) analysis.</div></div><div><h3>Results</h3><div>Plastic surgery applicants from 2023 to 2024 submitted more applications (85.1 vs 67.3, p &lt; 0.001) and received fewer interview offers (12.5 vs 15.7, p = 0.003) than 2017 to 2022 applicants. 2023 to 2024 interview offers were more evenly distributed (SD: 8.25 vs 10.5, p = 0.001). Applications employing a signal were more likely to receive an interview (OR: 5.72, p &lt; 0.001) and subsequently match (OR: 5.19, p &lt; 0.001). Applications where students had done away rotations were significantly more likely to result in an interview offer (OR: 30.2, p &lt; 0.001) and a match (OR: 27.4, p &lt; 0.001). There was no significant difference in application number, Step 2 CK scores or honored clerkships between matched and unmatched 2023 to 2024 applicants.</div></div><div><h3>Conclusions</h3><div>The implementation of preference signaling in the integrated plastic surgery residency application process appears to have corresponded to an increase in average applications per student, decreased interview offers and more evenly distributed interviews among applicants. Away rotations, preference signals and geographic connections seem to most strongly predict whether an application results in a successful match.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103467"},"PeriodicalIF":2.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}