Orthopedic residency programs have evolved significantly over the past few years, but are the changes for the better?
An article published in the Journal of Bone & Joint Surgery gives some perspective on recent issues and controversy in preparing orthopedic residents for further training and medical practice. Recent changes to orthopedic residency include:
• Duty hour restriction
• On-call responsibilities
• Emphasis on core competencies
Kyle J. Jeray, MD, and Steven L. Frick, MD, authored the article. They surveyed orthopedic residents and received 157 responses. Here are five key observations:
1. There were 69 percent of the respondents who thought the case logs and minimum number of surgical procedures effectively monitored their work. However, they also conceded these strategies weren't the only way to monitor their educational progress.
2. Of the residents, 32 percent did not believe minimums should be required.
3. An overwhelming number of respondents thought important cases were missing from the currently proposed "core surgical minimums," including distal radial fracture fixation and humeral fracture fixation. There are 16 core surgical minimum areas.
4. Individual resident surgical ability shouldn't be evaluated just on case minimums, according to the study. The authors suggest developing methods measuring surgical proficiency in addition to case minimums.
5. Surgical proficiency assessment can be measured in:
• Surgical skill labs
• Proctoring residents who perform procedures independently
• Faculty 360 degree evaluations
"Combining these types of assessments with surgical case logs documenting the residents' educational experience seems to be the best path going forward for assessing the development of younger surgeons," the study authors recommended.