Optimizing the surgical residents' educational experience on transplant surgery.

INTRODUCTION: Surgical specialties with high service demands like transplant surgery are challenged to provide good educational value for rotating surgical residents while maintaining quality patient care. Based on poor resident evaluations, the Resident Review Committee for Surgery (RRC-S) has proposed removing the requirement for transplant surgery rotations from general surgery residency programs.

OBJECTIVES: The objectives of this article are to provide a situation analysis pertaining to the problem of poor resident evaluations from the perspective of the American Society of Transplant Surgeons (ASTS), and to propose an action plan to improve the current situation.

SETTING AND PARTICIPANTS: The Fellowship Training and Curriculum committees of the ASTS together with ASTS leadership and ASTS fellowship program directors collaborated to address these concerns by identifying key contributory factors and by initiating an action plan to correct them.

RESULTS: The following 4 major issues pertaining to transplant surgery rotations were considered most relevant to the problem: (1) high service demands, (2) inadequate prioritization of resident education, (3) competition with fellows for educational opportunities, and (4) the need by many programs to send their residents to other centers to obtain transplant experience. Based on these issues, the ASTS leadership issued directives to all programs with rotating residents to (1) designate a transplant surgeon to resident education experience on transplant; (2) create a service infrastructure that is not dependent on surgical residents; (3) re-educate faculty, fellows, support staff and residents regarding resident expectations on transplant surgery; (4) create a structured and sustainable educational experience; (5) increase resident involvement in surgical procedures; and (6) obtain ongoing feedback from rotating residents and the program directors.

CONCLUSIONS: Transplant surgery can be a valuable educational experience for surgical residents. The ASTS is dedicated to collaborating with general surgery residents and program directors in ongoing efforts to enhance this experience.