The resident experience on trauma

Declining surgical opportunities and career incentives? analysis of data from a large multi-institutional study

Samir M. Fakhry, Dorraine D. Watts, Christopher Michetti, John P. Hunt, Thomas Scalea, Carnell Cooper, Brian Daley, Blaine Enderson, Keith D. Clancy, Andrew B. Peitzman, Michael D. Pasquale, Stanley J. Kurek, Ajai K. Malhotra, Timothy Fabian, Wendy L. Wahl, Karla S. Ahrns, Jeffrey Morken, Arthur L. Ney, Terrence H. Liu, Frederick A. Moore & 161 others Eddy Carrillo, James Lukan, Bernard Boulanger, F. Barry Knotts, Wendy Sue Shreve, John F. Bilello, James W. Davis, Ivan Puente, Sharon S. Cohen, John C. Layke, Scott Monk, Robert Marburger, Tiffany Bee, William F. Pfeifer, April Settell, Scott H. Norwood, Van L. Vallina, Pamela A. Nichols, Charles E. Wiles, Larry M. Jones, Victor L. Landry, Fred A. Luchette, Scott B. Frame, Lisa A. Patterson, Kathy Coon, Daniel Powers, Anne Kuzas, David G. Jacobs, Jennifer Sarafin, Ronald G. Albuquerque, Charles J. Yowler, Mitchell Scott Farber, Farouck N. Obeid, Jeffrey P. Salomone, Grace S. Rozycki, Sherry Melton, James M. Cross, Michael Haraschak, Michael C. Chang, Curt S. Koontz, Mauricio Lynn, Lonnie W. Frei, Antoinette Kanne, Dennis Wang, Peter Rhee, Benjamin D. Mosher, David Kam, Pascal O. Udekwu, Dale Oller, James V. Yuschak, Robert A. Jubelelirer, David J. Dries, Michael D. McGonigal, Uretz J. Oliphant, James S. Gregory, Mark Gestring, Paul Dabrowski, Juan A. Asensio, Walter Forno, Gustavo Roldan, Joan Huffman, Raymond Talucci, Gary Welch, Barbara Esposito, Jose A. Acosta, Pablo Rodriguez, C. M. Buechler, Leanne Adams, Dennis W. Ashley, Macram Ayoub, Stuart Chow, Kwang Suh, Gerard Fulda, Dennis C. Gore, William J. Mileski, Carl P. Valenziano, Anne O'Neill, Imtiaz A. Munshi, Wayne Vander Kolk, Paul Kemmeter, Jon Walsh, Mary B. Myers, Lewis J. Kaplan, Thomas Santora, Judith Johnson, Paula Griner, Nirav Patel, Thomas Cogbill, Michael F. Rotondo, Scott G. Sagraves, Daniel C. Cullinane, Susan Schrage, Andrew J. Kerwin, Raymond P. Bynoe, Lawrence Lottenberg, Robert Holtzman, Vicki J. Bennett-Shipman, Michael Schurr, Monica Newton, Jeffery Rosen, Christopher Salvino, Paul Bankey, Brian J. Norkiewicz, Robert A. Cherry, Eliza Enriquez, Juan L. Peschiera, W. Michael Johnson, John B. Holcomb, Russell Dumire, John R. Hall, George M. Testerman, Donald H. Jenkins, John D. Josephs, Christopher Wohltmann, A. Jay Raimonde, Arthur B. Dalton, Leonard J. Weireter, Frederic J. Cole, William Marx, Emily M. Sposato, Richard Pomerantz, Om P. Sharma, Michael Oswanshi, Faran Bokhari, Kimberly Nagy, Mary E. Fallat, Vicki Hardwick-Barnes, Deborah Baker, Judith Phillips, Don R. Fishman, Pauline Park, Murray Cohen, Mary Jo Wright, John Hunt, Michael Moncure, Jeff Strickler, John A. Bonadies, Judith A. O'Connor, John E. Sutton, Eileen Corcoran, Frederick B. Rogers, Jonathan Kohn, Dennis B. Dove, Dan A. Galvan, Kathleen P. O’hara, Hans Joseph Schmidt, Leon Pachter, Juan Grau, Kathleen A. LaVorgna, J. P. Dineen, Sheila Staib, L. F. Diamelio, Sharon Buchro, Patrick A. Dietz, Diane Higgins, J. Martin Perez, Collin E.M. Brathwaite, Karyn Butler, Karlene Sinclair, S. M. Siram, Hani Seoudi

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Purpose The surgical resident experience with trauma has changed. Many residents are exposed to predominantly nonoperative patient care experiences while on trauma rotations. Data from a large multicenter study were analyzed to estimate surgical resident exposure to trauma laparotomy, diagnostic peritoneal lavage (DPL), and focused abdominal sonography for trauma (U/S). Methods Centers completed a self-report questionnaire on their institutional demographics, admissions, and procedure for a 2-year period (1998-1999). Results A total of 82 trauma centers that provide resident teaching were included. The included centers represent over 247,000 trauma admissions. The majority of trauma centers (65.9%) had > 80% blunt injury. Although all centers performed laparotomies, other results were more variable. For U/S, 24.2% performed none at all and 47.0% performed fewer than two U/S examinations per month. For DPLs, 3.8% performed none and 66.7% performed fewer than two per month. Assuming 1 night of 4 on call, the average surgical resident training at a trauma center performing > 80% blunt trauma has the potential to participate in only 15 trauma laparotomies, 6 diagnostic peritoneal lavages, and 45 ultrasound examinations per year. In addition, the resident will care for an average of 500 blunt trauma patients before performing a splenectomy or liver repair. Conclusion Surgical resident experience on most trauma services is heavily weighted to nonoperative management, with a relatively low number of procedures, little experience with DPL, and highly variable experience with ultrasound. These data have serious implications for resident training and recruitment into the specialty.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalJournal of Trauma
Volume54
Issue number1
DOIs
StatePublished - Jan 1 2003

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Motivation
Wounds and Injuries
Peritoneal Lavage
Trauma Centers
Laparotomy
Nonpenetrating Wounds
Splenectomy
Self Report
Multicenter Studies
Ultrasonography
Patient Care
Teaching
Demography
Liver

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

The resident experience on trauma : Declining surgical opportunities and career incentives? analysis of data from a large multi-institutional study. / Fakhry, Samir M.; Watts, Dorraine D.; Michetti, Christopher; Hunt, John P.; Scalea, Thomas; Cooper, Carnell; Daley, Brian; Enderson, Blaine; Clancy, Keith D.; Peitzman, Andrew B.; Pasquale, Michael D.; Kurek, Stanley J.; Malhotra, Ajai K.; Fabian, Timothy; Wahl, Wendy L.; Ahrns, Karla S.; Morken, Jeffrey; Ney, Arthur L.; Liu, Terrence H.; Moore, Frederick A.; Carrillo, Eddy; Lukan, James; Boulanger, Bernard; Knotts, F. Barry; Shreve, Wendy Sue; Bilello, John F.; Davis, James W.; Puente, Ivan; Cohen, Sharon S.; Layke, John C.; Monk, Scott; Marburger, Robert; Bee, Tiffany; Pfeifer, William F.; Settell, April; Norwood, Scott H.; Vallina, Van L.; Nichols, Pamela A.; Wiles, Charles E.; Jones, Larry M.; Landry, Victor L.; Luchette, Fred A.; Frame, Scott B.; Patterson, Lisa A.; Coon, Kathy; Powers, Daniel; Kuzas, Anne; Jacobs, David G.; Sarafin, Jennifer; Albuquerque, Ronald G.; Yowler, Charles J.; Farber, Mitchell Scott; Obeid, Farouck N.; Salomone, Jeffrey P.; Rozycki, Grace S.; Melton, Sherry; Cross, James M.; Haraschak, Michael; Chang, Michael C.; Koontz, Curt S.; Lynn, Mauricio; Frei, Lonnie W.; Kanne, Antoinette; Wang, Dennis; Rhee, Peter; Mosher, Benjamin D.; Kam, David; Udekwu, Pascal O.; Oller, Dale; Yuschak, James V.; Jubelelirer, Robert A.; Dries, David J.; McGonigal, Michael D.; Oliphant, Uretz J.; Gregory, James S.; Gestring, Mark; Dabrowski, Paul; Asensio, Juan A.; Forno, Walter; Roldan, Gustavo; Huffman, Joan; Talucci, Raymond; Welch, Gary; Esposito, Barbara; Acosta, Jose A.; Rodriguez, Pablo; Buechler, C. M.; Adams, Leanne; Ashley, Dennis W.; Ayoub, Macram; Chow, Stuart; Suh, Kwang; Fulda, Gerard; Gore, Dennis C.; Mileski, William J.; Valenziano, Carl P.; O'Neill, Anne; Munshi, Imtiaz A.; Kolk, Wayne Vander; Kemmeter, Paul; Walsh, Jon; Myers, Mary B.; Kaplan, Lewis J.; Santora, Thomas; Johnson, Judith; Griner, Paula; Patel, Nirav; Cogbill, Thomas; Rotondo, Michael F.; Sagraves, Scott G.; Cullinane, Daniel C.; Schrage, Susan; Kerwin, Andrew J.; Bynoe, Raymond P.; Lottenberg, Lawrence; Holtzman, Robert; Bennett-Shipman, Vicki J.; Schurr, Michael; Newton, Monica; Rosen, Jeffery; Salvino, Christopher; Bankey, Paul; Norkiewicz, Brian J.; Cherry, Robert A.; Enriquez, Eliza; Peschiera, Juan L.; Johnson, W. Michael; Holcomb, John B.; Dumire, Russell; Hall, John R.; Testerman, George M.; Jenkins, Donald H.; Josephs, John D.; Wohltmann, Christopher; Raimonde, A. Jay; Dalton, Arthur B.; Weireter, Leonard J.; Cole, Frederic J.; Marx, William; Sposato, Emily M.; Pomerantz, Richard; Sharma, Om P.; Oswanshi, Michael; Bokhari, Faran; Nagy, Kimberly; Fallat, Mary E.; Hardwick-Barnes, Vicki; Baker, Deborah; Phillips, Judith; Fishman, Don R.; Park, Pauline; Cohen, Murray; Wright, Mary Jo; Hunt, John; Moncure, Michael; Strickler, Jeff; Bonadies, John A.; O'Connor, Judith A.; Sutton, John E.; Corcoran, Eileen; Rogers, Frederick B.; Kohn, Jonathan; Dove, Dennis B.; Galvan, Dan A.; O’hara, Kathleen P.; Schmidt, Hans Joseph; Pachter, Leon; Grau, Juan; LaVorgna, Kathleen A.; Dineen, J. P.; Staib, Sheila; Diamelio, L. F.; Buchro, Sharon; Dietz, Patrick A.; Higgins, Diane; Perez, J. Martin; Brathwaite, Collin E.M.; Butler, Karyn; Sinclair, Karlene; Siram, S. M.; Seoudi, Hani.

In: Journal of Trauma, Vol. 54, No. 1, 01.01.2003, p. 1-8.

Research output: Contribution to journalArticle

Fakhry, SM, Watts, DD, Michetti, C, Hunt, JP, Scalea, T, Cooper, C, Daley, B, Enderson, B, Clancy, KD, Peitzman, AB, Pasquale, MD, Kurek, SJ, Malhotra, AK, Fabian, T, Wahl, WL, Ahrns, KS, Morken, J, Ney, AL, Liu, TH, Moore, FA, Carrillo, E, Lukan, J, Boulanger, B, Knotts, FB, Shreve, WS, Bilello, JF, Davis, JW, Puente, I, Cohen, SS, Layke, JC, Monk, S, Marburger, R, Bee, T, Pfeifer, WF, Settell, A, Norwood, SH, Vallina, VL, Nichols, PA, Wiles, CE, Jones, LM, Landry, VL, Luchette, FA, Frame, SB, Patterson, LA, Coon, K, Powers, D, Kuzas, A, Jacobs, DG, Sarafin, J, Albuquerque, RG, Yowler, CJ, Farber, MS, Obeid, FN, Salomone, JP, Rozycki, GS, Melton, S, Cross, JM, Haraschak, M, Chang, MC, Koontz, CS, Lynn, M, Frei, LW, Kanne, A, Wang, D, Rhee, P, Mosher, BD, Kam, D, Udekwu, PO, Oller, D, Yuschak, JV, Jubelelirer, RA, Dries, DJ, McGonigal, MD, Oliphant, UJ, Gregory, JS, Gestring, M, Dabrowski, P, Asensio, JA, Forno, W, Roldan, G, Huffman, J, Talucci, R, Welch, G, Esposito, B, Acosta, JA, Rodriguez, P, Buechler, CM, Adams, L, Ashley, DW, Ayoub, M, Chow, S, Suh, K, Fulda, G, Gore, DC, Mileski, WJ, Valenziano, CP, O'Neill, A, Munshi, IA, Kolk, WV, Kemmeter, P, Walsh, J, Myers, MB, Kaplan, LJ, Santora, T, Johnson, J, Griner, P, Patel, N, Cogbill, T, Rotondo, MF, Sagraves, SG, Cullinane, DC, Schrage, S, Kerwin, AJ, Bynoe, RP, Lottenberg, L, Holtzman, R, Bennett-Shipman, VJ, Schurr, M, Newton, M, Rosen, J, Salvino, C, Bankey, P, Norkiewicz, BJ, Cherry, RA, Enriquez, E, Peschiera, JL, Johnson, WM, Holcomb, JB, Dumire, R, Hall, JR, Testerman, GM, Jenkins, DH, Josephs, JD, Wohltmann, C, Raimonde, AJ, Dalton, AB, Weireter, LJ, Cole, FJ, Marx, W, Sposato, EM, Pomerantz, R, Sharma, OP, Oswanshi, M, Bokhari, F, Nagy, K, Fallat, ME, Hardwick-Barnes, V, Baker, D, Phillips, J, Fishman, DR, Park, P, Cohen, M, Wright, MJ, Hunt, J, Moncure, M, Strickler, J, Bonadies, JA, O'Connor, JA, Sutton, JE, Corcoran, E, Rogers, FB, Kohn, J, Dove, DB, Galvan, DA, O’hara, KP, Schmidt, HJ, Pachter, L, Grau, J, LaVorgna, KA, Dineen, JP, Staib, S, Diamelio, LF, Buchro, S, Dietz, PA, Higgins, D, Perez, JM, Brathwaite, CEM, Butler, K, Sinclair, K, Siram, SM & Seoudi, H 2003, 'The resident experience on trauma: Declining surgical opportunities and career incentives? analysis of data from a large multi-institutional study', Journal of Trauma, vol. 54, no. 1, pp. 1-8. https://doi.org/10.1097/00005373-200301000-00001
Fakhry, Samir M. ; Watts, Dorraine D. ; Michetti, Christopher ; Hunt, John P. ; Scalea, Thomas ; Cooper, Carnell ; Daley, Brian ; Enderson, Blaine ; Clancy, Keith D. ; Peitzman, Andrew B. ; Pasquale, Michael D. ; Kurek, Stanley J. ; Malhotra, Ajai K. ; Fabian, Timothy ; Wahl, Wendy L. ; Ahrns, Karla S. ; Morken, Jeffrey ; Ney, Arthur L. ; Liu, Terrence H. ; Moore, Frederick A. ; Carrillo, Eddy ; Lukan, James ; Boulanger, Bernard ; Knotts, F. Barry ; Shreve, Wendy Sue ; Bilello, John F. ; Davis, James W. ; Puente, Ivan ; Cohen, Sharon S. ; Layke, John C. ; Monk, Scott ; Marburger, Robert ; Bee, Tiffany ; Pfeifer, William F. ; Settell, April ; Norwood, Scott H. ; Vallina, Van L. ; Nichols, Pamela A. ; Wiles, Charles E. ; Jones, Larry M. ; Landry, Victor L. ; Luchette, Fred A. ; Frame, Scott B. ; Patterson, Lisa A. ; Coon, Kathy ; Powers, Daniel ; Kuzas, Anne ; Jacobs, David G. ; Sarafin, Jennifer ; Albuquerque, Ronald G. ; Yowler, Charles J. ; Farber, Mitchell Scott ; Obeid, Farouck N. ; Salomone, Jeffrey P. ; Rozycki, Grace S. ; Melton, Sherry ; Cross, James M. ; Haraschak, Michael ; Chang, Michael C. ; Koontz, Curt S. ; Lynn, Mauricio ; Frei, Lonnie W. ; Kanne, Antoinette ; Wang, Dennis ; Rhee, Peter ; Mosher, Benjamin D. ; Kam, David ; Udekwu, Pascal O. ; Oller, Dale ; Yuschak, James V. ; Jubelelirer, Robert A. ; Dries, David J. ; McGonigal, Michael D. ; Oliphant, Uretz J. ; Gregory, James S. ; Gestring, Mark ; Dabrowski, Paul ; Asensio, Juan A. ; Forno, Walter ; Roldan, Gustavo ; Huffman, Joan ; Talucci, Raymond ; Welch, Gary ; Esposito, Barbara ; Acosta, Jose A. ; Rodriguez, Pablo ; Buechler, C. M. ; Adams, Leanne ; Ashley, Dennis W. ; Ayoub, Macram ; Chow, Stuart ; Suh, Kwang ; Fulda, Gerard ; Gore, Dennis C. ; Mileski, William J. ; Valenziano, Carl P. ; O'Neill, Anne ; Munshi, Imtiaz A. ; Kolk, Wayne Vander ; Kemmeter, Paul ; Walsh, Jon ; Myers, Mary B. ; Kaplan, Lewis J. ; Santora, Thomas ; Johnson, Judith ; Griner, Paula ; Patel, Nirav ; Cogbill, Thomas ; Rotondo, Michael F. ; Sagraves, Scott G. ; Cullinane, Daniel C. ; Schrage, Susan ; Kerwin, Andrew J. ; Bynoe, Raymond P. ; Lottenberg, Lawrence ; Holtzman, Robert ; Bennett-Shipman, Vicki J. ; Schurr, Michael ; Newton, Monica ; Rosen, Jeffery ; Salvino, Christopher ; Bankey, Paul ; Norkiewicz, Brian J. ; Cherry, Robert A. ; Enriquez, Eliza ; Peschiera, Juan L. ; Johnson, W. Michael ; Holcomb, John B. ; Dumire, Russell ; Hall, John R. ; Testerman, George M. ; Jenkins, Donald H. ; Josephs, John D. ; Wohltmann, Christopher ; Raimonde, A. Jay ; Dalton, Arthur B. ; Weireter, Leonard J. ; Cole, Frederic J. ; Marx, William ; Sposato, Emily M. ; Pomerantz, Richard ; Sharma, Om P. ; Oswanshi, Michael ; Bokhari, Faran ; Nagy, Kimberly ; Fallat, Mary E. ; Hardwick-Barnes, Vicki ; Baker, Deborah ; Phillips, Judith ; Fishman, Don R. ; Park, Pauline ; Cohen, Murray ; Wright, Mary Jo ; Hunt, John ; Moncure, Michael ; Strickler, Jeff ; Bonadies, John A. ; O'Connor, Judith A. ; Sutton, John E. ; Corcoran, Eileen ; Rogers, Frederick B. ; Kohn, Jonathan ; Dove, Dennis B. ; Galvan, Dan A. ; O’hara, Kathleen P. ; Schmidt, Hans Joseph ; Pachter, Leon ; Grau, Juan ; LaVorgna, Kathleen A. ; Dineen, J. P. ; Staib, Sheila ; Diamelio, L. F. ; Buchro, Sharon ; Dietz, Patrick A. ; Higgins, Diane ; Perez, J. Martin ; Brathwaite, Collin E.M. ; Butler, Karyn ; Sinclair, Karlene ; Siram, S. M. ; Seoudi, Hani. / The resident experience on trauma : Declining surgical opportunities and career incentives? analysis of data from a large multi-institutional study. In: Journal of Trauma. 2003 ; Vol. 54, No. 1. pp. 1-8.
@article{845f60a5d81e497c894300dab9ebc121,
title = "The resident experience on trauma: Declining surgical opportunities and career incentives? analysis of data from a large multi-institutional study",
abstract = "Purpose The surgical resident experience with trauma has changed. Many residents are exposed to predominantly nonoperative patient care experiences while on trauma rotations. Data from a large multicenter study were analyzed to estimate surgical resident exposure to trauma laparotomy, diagnostic peritoneal lavage (DPL), and focused abdominal sonography for trauma (U/S). Methods Centers completed a self-report questionnaire on their institutional demographics, admissions, and procedure for a 2-year period (1998-1999). Results A total of 82 trauma centers that provide resident teaching were included. The included centers represent over 247,000 trauma admissions. The majority of trauma centers (65.9{\%}) had > 80{\%} blunt injury. Although all centers performed laparotomies, other results were more variable. For U/S, 24.2{\%} performed none at all and 47.0{\%} performed fewer than two U/S examinations per month. For DPLs, 3.8{\%} performed none and 66.7{\%} performed fewer than two per month. Assuming 1 night of 4 on call, the average surgical resident training at a trauma center performing > 80{\%} blunt trauma has the potential to participate in only 15 trauma laparotomies, 6 diagnostic peritoneal lavages, and 45 ultrasound examinations per year. In addition, the resident will care for an average of 500 blunt trauma patients before performing a splenectomy or liver repair. Conclusion Surgical resident experience on most trauma services is heavily weighted to nonoperative management, with a relatively low number of procedures, little experience with DPL, and highly variable experience with ultrasound. These data have serious implications for resident training and recruitment into the specialty.",
author = "Fakhry, {Samir M.} and Watts, {Dorraine D.} and Christopher Michetti and Hunt, {John P.} and Thomas Scalea and Carnell Cooper and Brian Daley and Blaine Enderson and Clancy, {Keith D.} and Peitzman, {Andrew B.} and Pasquale, {Michael D.} and Kurek, {Stanley J.} and Malhotra, {Ajai K.} and Timothy Fabian and Wahl, {Wendy L.} and Ahrns, {Karla S.} and Jeffrey Morken and Ney, {Arthur L.} and Liu, {Terrence H.} and Moore, {Frederick A.} and Eddy Carrillo and James Lukan and Bernard Boulanger and Knotts, {F. Barry} and Shreve, {Wendy Sue} and Bilello, {John F.} and Davis, {James W.} and Ivan Puente and Cohen, {Sharon S.} and Layke, {John C.} and Scott Monk and Robert Marburger and Tiffany Bee and Pfeifer, {William F.} and April Settell and Norwood, {Scott H.} and Vallina, {Van L.} and Nichols, {Pamela A.} and Wiles, {Charles E.} and Jones, {Larry M.} and Landry, {Victor L.} and Luchette, {Fred A.} and Frame, {Scott B.} and Patterson, {Lisa A.} and Kathy Coon and Daniel Powers and Anne Kuzas and Jacobs, {David G.} and Jennifer Sarafin and Albuquerque, {Ronald G.} and Yowler, {Charles J.} and Farber, {Mitchell Scott} and Obeid, {Farouck N.} and Salomone, {Jeffrey P.} and Rozycki, {Grace S.} and Sherry Melton and Cross, {James M.} and Michael Haraschak and Chang, {Michael C.} and Koontz, {Curt S.} and Mauricio Lynn and Frei, {Lonnie W.} and Antoinette Kanne and Dennis Wang and Peter Rhee and Mosher, {Benjamin D.} and David Kam and Udekwu, {Pascal O.} and Dale Oller and Yuschak, {James V.} and Jubelelirer, {Robert A.} and Dries, {David J.} and McGonigal, {Michael D.} and Oliphant, {Uretz J.} and Gregory, {James S.} and Mark Gestring and Paul Dabrowski and Asensio, {Juan A.} and Walter Forno and Gustavo Roldan and Joan Huffman and Raymond Talucci and Gary Welch and Barbara Esposito and Acosta, {Jose A.} and Pablo Rodriguez and Buechler, {C. M.} and Leanne Adams and Ashley, {Dennis W.} and Macram Ayoub and Stuart Chow and Kwang Suh and Gerard Fulda and Gore, {Dennis C.} and Mileski, {William J.} and Valenziano, {Carl P.} and Anne O'Neill and Munshi, {Imtiaz A.} and Kolk, {Wayne Vander} and Paul Kemmeter and Jon Walsh and Myers, {Mary B.} and Kaplan, {Lewis J.} and Thomas Santora and Judith Johnson and Paula Griner and Nirav Patel and Thomas Cogbill and Rotondo, {Michael F.} and Sagraves, {Scott G.} and Cullinane, {Daniel C.} and Susan Schrage and Kerwin, {Andrew J.} and Bynoe, {Raymond P.} and Lawrence Lottenberg and Robert Holtzman and Bennett-Shipman, {Vicki J.} and Michael Schurr and Monica Newton and Jeffery Rosen and Christopher Salvino and Paul Bankey and Norkiewicz, {Brian J.} and Cherry, {Robert A.} and Eliza Enriquez and Peschiera, {Juan L.} and Johnson, {W. Michael} and Holcomb, {John B.} and Russell Dumire and Hall, {John R.} and Testerman, {George M.} and Jenkins, {Donald H.} and Josephs, {John D.} and Christopher Wohltmann and Raimonde, {A. Jay} and Dalton, {Arthur B.} and Weireter, {Leonard J.} and Cole, {Frederic J.} and William Marx and Sposato, {Emily M.} and Richard Pomerantz and Sharma, {Om P.} and Michael Oswanshi and Faran Bokhari and Kimberly Nagy and Fallat, {Mary E.} and Vicki Hardwick-Barnes and Deborah Baker and Judith Phillips and Fishman, {Don R.} and Pauline Park and Murray Cohen and Wright, {Mary Jo} and John Hunt and Michael Moncure and Jeff Strickler and Bonadies, {John A.} and O'Connor, {Judith A.} and Sutton, {John E.} and Eileen Corcoran and Rogers, {Frederick B.} and Jonathan Kohn and Dove, {Dennis B.} and Galvan, {Dan A.} and O’hara, {Kathleen P.} and Schmidt, {Hans Joseph} and Leon Pachter and Juan Grau and LaVorgna, {Kathleen A.} and Dineen, {J. P.} and Sheila Staib and Diamelio, {L. F.} and Sharon Buchro and Dietz, {Patrick A.} and Diane Higgins and Perez, {J. Martin} and Brathwaite, {Collin E.M.} and Karyn Butler and Karlene Sinclair and Siram, {S. M.} and Hani Seoudi",
year = "2003",
month = "1",
day = "1",
doi = "10.1097/00005373-200301000-00001",
language = "English (US)",
volume = "54",
pages = "1--8",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - The resident experience on trauma

T2 - Declining surgical opportunities and career incentives? analysis of data from a large multi-institutional study

AU - Fakhry, Samir M.

AU - Watts, Dorraine D.

AU - Michetti, Christopher

AU - Hunt, John P.

AU - Scalea, Thomas

AU - Cooper, Carnell

AU - Daley, Brian

AU - Enderson, Blaine

AU - Clancy, Keith D.

AU - Peitzman, Andrew B.

AU - Pasquale, Michael D.

AU - Kurek, Stanley J.

AU - Malhotra, Ajai K.

AU - Fabian, Timothy

AU - Wahl, Wendy L.

AU - Ahrns, Karla S.

AU - Morken, Jeffrey

AU - Ney, Arthur L.

AU - Liu, Terrence H.

AU - Moore, Frederick A.

AU - Carrillo, Eddy

AU - Lukan, James

AU - Boulanger, Bernard

AU - Knotts, F. Barry

AU - Shreve, Wendy Sue

AU - Bilello, John F.

AU - Davis, James W.

AU - Puente, Ivan

AU - Cohen, Sharon S.

AU - Layke, John C.

AU - Monk, Scott

AU - Marburger, Robert

AU - Bee, Tiffany

AU - Pfeifer, William F.

AU - Settell, April

AU - Norwood, Scott H.

AU - Vallina, Van L.

AU - Nichols, Pamela A.

AU - Wiles, Charles E.

AU - Jones, Larry M.

AU - Landry, Victor L.

AU - Luchette, Fred A.

AU - Frame, Scott B.

AU - Patterson, Lisa A.

AU - Coon, Kathy

AU - Powers, Daniel

AU - Kuzas, Anne

AU - Jacobs, David G.

AU - Sarafin, Jennifer

AU - Albuquerque, Ronald G.

AU - Yowler, Charles J.

AU - Farber, Mitchell Scott

AU - Obeid, Farouck N.

AU - Salomone, Jeffrey P.

AU - Rozycki, Grace S.

AU - Melton, Sherry

AU - Cross, James M.

AU - Haraschak, Michael

AU - Chang, Michael C.

AU - Koontz, Curt S.

AU - Lynn, Mauricio

AU - Frei, Lonnie W.

AU - Kanne, Antoinette

AU - Wang, Dennis

AU - Rhee, Peter

AU - Mosher, Benjamin D.

AU - Kam, David

AU - Udekwu, Pascal O.

AU - Oller, Dale

AU - Yuschak, James V.

AU - Jubelelirer, Robert A.

AU - Dries, David J.

AU - McGonigal, Michael D.

AU - Oliphant, Uretz J.

AU - Gregory, James S.

AU - Gestring, Mark

AU - Dabrowski, Paul

AU - Asensio, Juan A.

AU - Forno, Walter

AU - Roldan, Gustavo

AU - Huffman, Joan

AU - Talucci, Raymond

AU - Welch, Gary

AU - Esposito, Barbara

AU - Acosta, Jose A.

AU - Rodriguez, Pablo

AU - Buechler, C. M.

AU - Adams, Leanne

AU - Ashley, Dennis W.

AU - Ayoub, Macram

AU - Chow, Stuart

AU - Suh, Kwang

AU - Fulda, Gerard

AU - Gore, Dennis C.

AU - Mileski, William J.

AU - Valenziano, Carl P.

AU - O'Neill, Anne

AU - Munshi, Imtiaz A.

AU - Kolk, Wayne Vander

AU - Kemmeter, Paul

AU - Walsh, Jon

AU - Myers, Mary B.

AU - Kaplan, Lewis J.

AU - Santora, Thomas

AU - Johnson, Judith

AU - Griner, Paula

AU - Patel, Nirav

AU - Cogbill, Thomas

AU - Rotondo, Michael F.

AU - Sagraves, Scott G.

AU - Cullinane, Daniel C.

AU - Schrage, Susan

AU - Kerwin, Andrew J.

AU - Bynoe, Raymond P.

AU - Lottenberg, Lawrence

AU - Holtzman, Robert

AU - Bennett-Shipman, Vicki J.

AU - Schurr, Michael

AU - Newton, Monica

AU - Rosen, Jeffery

AU - Salvino, Christopher

AU - Bankey, Paul

AU - Norkiewicz, Brian J.

AU - Cherry, Robert A.

AU - Enriquez, Eliza

AU - Peschiera, Juan L.

AU - Johnson, W. Michael

AU - Holcomb, John B.

AU - Dumire, Russell

AU - Hall, John R.

AU - Testerman, George M.

AU - Jenkins, Donald H.

AU - Josephs, John D.

AU - Wohltmann, Christopher

AU - Raimonde, A. Jay

AU - Dalton, Arthur B.

AU - Weireter, Leonard J.

AU - Cole, Frederic J.

AU - Marx, William

AU - Sposato, Emily M.

AU - Pomerantz, Richard

AU - Sharma, Om P.

AU - Oswanshi, Michael

AU - Bokhari, Faran

AU - Nagy, Kimberly

AU - Fallat, Mary E.

AU - Hardwick-Barnes, Vicki

AU - Baker, Deborah

AU - Phillips, Judith

AU - Fishman, Don R.

AU - Park, Pauline

AU - Cohen, Murray

AU - Wright, Mary Jo

AU - Hunt, John

AU - Moncure, Michael

AU - Strickler, Jeff

AU - Bonadies, John A.

AU - O'Connor, Judith A.

AU - Sutton, John E.

AU - Corcoran, Eileen

AU - Rogers, Frederick B.

AU - Kohn, Jonathan

AU - Dove, Dennis B.

AU - Galvan, Dan A.

AU - O’hara, Kathleen P.

AU - Schmidt, Hans Joseph

AU - Pachter, Leon

AU - Grau, Juan

AU - LaVorgna, Kathleen A.

AU - Dineen, J. P.

AU - Staib, Sheila

AU - Diamelio, L. F.

AU - Buchro, Sharon

AU - Dietz, Patrick A.

AU - Higgins, Diane

AU - Perez, J. Martin

AU - Brathwaite, Collin E.M.

AU - Butler, Karyn

AU - Sinclair, Karlene

AU - Siram, S. M.

AU - Seoudi, Hani

PY - 2003/1/1

Y1 - 2003/1/1

N2 - Purpose The surgical resident experience with trauma has changed. Many residents are exposed to predominantly nonoperative patient care experiences while on trauma rotations. Data from a large multicenter study were analyzed to estimate surgical resident exposure to trauma laparotomy, diagnostic peritoneal lavage (DPL), and focused abdominal sonography for trauma (U/S). Methods Centers completed a self-report questionnaire on their institutional demographics, admissions, and procedure for a 2-year period (1998-1999). Results A total of 82 trauma centers that provide resident teaching were included. The included centers represent over 247,000 trauma admissions. The majority of trauma centers (65.9%) had > 80% blunt injury. Although all centers performed laparotomies, other results were more variable. For U/S, 24.2% performed none at all and 47.0% performed fewer than two U/S examinations per month. For DPLs, 3.8% performed none and 66.7% performed fewer than two per month. Assuming 1 night of 4 on call, the average surgical resident training at a trauma center performing > 80% blunt trauma has the potential to participate in only 15 trauma laparotomies, 6 diagnostic peritoneal lavages, and 45 ultrasound examinations per year. In addition, the resident will care for an average of 500 blunt trauma patients before performing a splenectomy or liver repair. Conclusion Surgical resident experience on most trauma services is heavily weighted to nonoperative management, with a relatively low number of procedures, little experience with DPL, and highly variable experience with ultrasound. These data have serious implications for resident training and recruitment into the specialty.

AB - Purpose The surgical resident experience with trauma has changed. Many residents are exposed to predominantly nonoperative patient care experiences while on trauma rotations. Data from a large multicenter study were analyzed to estimate surgical resident exposure to trauma laparotomy, diagnostic peritoneal lavage (DPL), and focused abdominal sonography for trauma (U/S). Methods Centers completed a self-report questionnaire on their institutional demographics, admissions, and procedure for a 2-year period (1998-1999). Results A total of 82 trauma centers that provide resident teaching were included. The included centers represent over 247,000 trauma admissions. The majority of trauma centers (65.9%) had > 80% blunt injury. Although all centers performed laparotomies, other results were more variable. For U/S, 24.2% performed none at all and 47.0% performed fewer than two U/S examinations per month. For DPLs, 3.8% performed none and 66.7% performed fewer than two per month. Assuming 1 night of 4 on call, the average surgical resident training at a trauma center performing > 80% blunt trauma has the potential to participate in only 15 trauma laparotomies, 6 diagnostic peritoneal lavages, and 45 ultrasound examinations per year. In addition, the resident will care for an average of 500 blunt trauma patients before performing a splenectomy or liver repair. Conclusion Surgical resident experience on most trauma services is heavily weighted to nonoperative management, with a relatively low number of procedures, little experience with DPL, and highly variable experience with ultrasound. These data have serious implications for resident training and recruitment into the specialty.

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U2 - 10.1097/00005373-200301000-00001

DO - 10.1097/00005373-200301000-00001

M3 - Article

VL - 54

SP - 1

EP - 8

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 1

ER -