Conference Coverage

Do fellowship programs help prepare general surgery residents for board exams?


 

AT THE ACS CLINICAL CONGRESS

WASHINGTON – Pass rates on the general surgery board exams were significantly higher for programs in which residents trained alongside surgical fellows, according to a retrospective study presented at the annual clinical congress of the American College of Surgeons.

The study adds another perspective to the ongoing debate about the impact of fellowships on general surgery residency and residency programs. Mohammed J. Al Fayyadh, MD, of the University of Texas Health Science Center at San Antonio and his associates investigated the impact of fellowships on program pass rates for general surgery boards. They reviewed American Board of Surgery exam data for the classes of 2010-2014, which included 242 programs (a total of 5,191 resident examinees), of which 148 had fellows participating (3,767 resident examinees).

Dr. Mohammed Al Fayyadh

Dr. Mohammed Al Fayyadh

The investigators focused on comparing pass rates between general surgery residents who trained with and without fellows in the program. The investigators also looked at the relationship between pass rates and the program fellow to general surgery resident (Fel:Res) ratio.

The findings suggest that having fellows in a program has a positive impact on the pass rates of those taking the ABS general surgery exam. Pass rates were significantly higher for general surgery programs with fellows. This trend held for all measures studied: Qualifying (written) exam (88% vs. 86%), certifying (oral) exam (83% vs. 80%), and combined exams (74% vs. 69%). Differences between the groups were statistically significant.

The pass rates tended to be higher in programs with higher Fel:Res ratios. For example, programs with a 1.5:1 Fel:Res ratio had the highest pass rates for the qualifying, certifying, and combined exams.

The impact of subspecialty fellowships on general surgery residencies has been the subject of research and debate in recent years. Some studies have suggested that subspecialty training for fellows has meant that general surgery residents have less opportunity to operate in areas such as trauma (“Trauma operative training declining for general surgery residents,” ACS Surgery News, Oct. 4, 2016) and vascular surgery (Ann Vasc Surg. 2016;33;98-102).

Taken in this context, it is possible that the programs with more fellows simply recruit more competitive residents who tend to do better on exams. However, this could also reflect more resources in fellowship programs that are available to all trainees or better mentorship opportunities, said Dr. Al Fayyadh. He concluded that more research is needed to tease out the impact of fellowship programs on general surgery resident education.

Dr. Al Fayyadh had no disclosures.

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