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Fellowship Training: A Self-fulfilling Prophecy: Comment on “Impact of Family and Gender on Career Goals”

Fellowship Training: A Self-fulfilling Prophecy: Comment on “Impact of Family and Gender on... Viola and colleagues have queried recent categorical general surgery residents to determine how gender, marriage, and family influence their decision to pursue specialty fellowship training. The authors found that 28.7% of residents believed general surgery is becoming obsolete and 55.1% believed specialty training is necessary to be successful. Single residents, men more than women, and married residents without children were more likely to have these opinions. Furthermore, female residents who were single or married without children tended to believe that fellowship training allows for more favorable lifestyles. As pointed out by Viola and colleagues, the number of fellowship positions has increased dramatically over the past decade, especially in the area of minimally invasive surgery, in which fellowships primarily focus on technical performance of procedures that should be learned in residency training. Baseline data from the parent survey identified that this group of residents was satisfied with their residency training.1 One must ask why that is if a large portion of these residents are planning to pursue fellowship training. One obvious explanation is that the residents believe they are being adequately trained to pursue a fellowship. Viola and colleagues noted that residents who believed further fellowship training was necessary were mostly training in academic programs with affiliated specialty fellowship programs. Although role models and mentors were not addressed in this study, it is not hard to imagine that residents in academic programs with fellowship-trained faculty and coexisting fellowship training programs are influenced directly or indirectly to pursue fellowship training. The impact of coexisting fellowship programs on residency training must be examined closely. Are the expectations of the faculty and the residents the same in residency programs with and without fellowship programs? Do residents get the same training with or without coexisting fellows? These are complicated questions but ones that must be evaluated and understood as we evolve our surgical training paradigms. One could argue that the coexistence of fellowship training with residency training has delayed the maturation of resident abilities such that further fellowship training has become a necessity, notwithstanding the other forces affecting surgery training, such as the 80-hour workweek. Although the surgical community has been discussing the growth of specialties and the changing domain of general surgery for the past 3 decades, we must redouble our efforts to develop efficient training programs that can meet the needs and expectations of patients in all venues as well as the needs of our trainees, both men and women. Back to top Article Information Correspondence: Dr Hebert, Department of Surgery, University of Vermont College of Medicine, Fletcher Allen Health Care, 111 Colchester Ave, Burlington, VT 05401 (james.hebert@vtmednet.org). Financial Disclosure: None reported. References 1. Yeo HViola KBerg D et al. Attitudes, training experiences, and professional expectations of US general surgery residents: a national survey. JAMA 2009;302 (12) 1301- 1308PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Fellowship Training: A Self-fulfilling Prophecy: Comment on “Impact of Family and Gender on Career Goals”

Archives of Surgery , Volume 145 (5) – May 1, 2010

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Publisher
American Medical Association
Copyright
Copyright © 2010 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.2010.63
Publisher site
See Article on Publisher Site

Abstract

Viola and colleagues have queried recent categorical general surgery residents to determine how gender, marriage, and family influence their decision to pursue specialty fellowship training. The authors found that 28.7% of residents believed general surgery is becoming obsolete and 55.1% believed specialty training is necessary to be successful. Single residents, men more than women, and married residents without children were more likely to have these opinions. Furthermore, female residents who were single or married without children tended to believe that fellowship training allows for more favorable lifestyles. As pointed out by Viola and colleagues, the number of fellowship positions has increased dramatically over the past decade, especially in the area of minimally invasive surgery, in which fellowships primarily focus on technical performance of procedures that should be learned in residency training. Baseline data from the parent survey identified that this group of residents was satisfied with their residency training.1 One must ask why that is if a large portion of these residents are planning to pursue fellowship training. One obvious explanation is that the residents believe they are being adequately trained to pursue a fellowship. Viola and colleagues noted that residents who believed further fellowship training was necessary were mostly training in academic programs with affiliated specialty fellowship programs. Although role models and mentors were not addressed in this study, it is not hard to imagine that residents in academic programs with fellowship-trained faculty and coexisting fellowship training programs are influenced directly or indirectly to pursue fellowship training. The impact of coexisting fellowship programs on residency training must be examined closely. Are the expectations of the faculty and the residents the same in residency programs with and without fellowship programs? Do residents get the same training with or without coexisting fellows? These are complicated questions but ones that must be evaluated and understood as we evolve our surgical training paradigms. One could argue that the coexistence of fellowship training with residency training has delayed the maturation of resident abilities such that further fellowship training has become a necessity, notwithstanding the other forces affecting surgery training, such as the 80-hour workweek. Although the surgical community has been discussing the growth of specialties and the changing domain of general surgery for the past 3 decades, we must redouble our efforts to develop efficient training programs that can meet the needs and expectations of patients in all venues as well as the needs of our trainees, both men and women. Back to top Article Information Correspondence: Dr Hebert, Department of Surgery, University of Vermont College of Medicine, Fletcher Allen Health Care, 111 Colchester Ave, Burlington, VT 05401 (james.hebert@vtmednet.org). Financial Disclosure: None reported. References 1. Yeo HViola KBerg D et al. Attitudes, training experiences, and professional expectations of US general surgery residents: a national survey. JAMA 2009;302 (12) 1301- 1308PubMedGoogle ScholarCrossref

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 2010

Keywords: gender

References