Formative perception of 4th and 5th year Pediatric Surgery residents in Spain.

Objectives: To evaluate the perception of autonomy and the main formative strengths and weaknesses of fourth-year (R4) and fifth-year (R5) Pediatric Surgery residents (MIR) in Spain, in order to identify areas for improvement in their surgical and clinical training.

Material and methods: A descriptive cross-sectional study was conducted using an anonymous survey distributed via Google Forms during the last quarter of 2023. The questionnaire included 8 questions on demographic data, surgical activity, outpatient clinics, and training suggestions. The results underwent a descriptive statistical analysis.

Results: Eighteen residents participated (11 women and 7 men), with a mean age of 29.6 years; 61% were MIR-5 and 39% MIR-4. R4s perceived greater autonomy in frequent procedures (open orchidopexy, inguinal herniorrhaphy, appendectomy, and upper gastrointestinal endoscopy) and less in neonatal surgery and urological pathology. R5s reported greater independence in common general surgery and less in esophageal atresia, diaphragmatic hernia, pyeloplasty, and nephrectomy. In outpatient clinics, autonomy was greater in abdominal and skin pathology, and lower in urology and head and neck pathology. Among the main limitations noted were the low volume of neonatal surgery, the high number of residents, and the scarce offer of structured training activities.

Conclusions: The lower perceived autonomy is concentrated in neonatal surgery and complex urological pathology. Coordinated training strategies are required at the national level, including surgical simulation, structured online training, and rotations in reference centers, to optimize the acquisition of competencies and ensure that training is as complete as possible.