Joshua J Weis1, Matthew Goldblatt2, Aurora Pryor3, Brian J Dunkin4, L M Brunt5, Daniel B Jones6, Daniel J Scott1. 1University of Texas Southwestern Medical Center at Dallas, 2Medical College of Wisconsin, 3Stony Brook University Department of Surgery, 4Houston Methodist Hospital, 5Washington University School of Medicine, 6Beth Israel Deaconess Medical Center
INTRODUCTION: The American health care system faces deficits in quality and quantity of surgeons. SAGES is a major stakeholder in surgical fellowship training and is responsible for defining the curriculum for the Advanced GI/MIS fellowship. SAGES leadership is actively adapting this curriculum based on the current educational climate.
METHODS AND PROCEDURES: The process of reform began in 2014 through a series of iterative meetings and discussions. A working group within the Resident and Fellow Training (RAFT) Committee reviewed de-identified case log data from fellows who trained from 2012-2015. These data were used to propose new case log criteria designed to provide adequate exposure to core content. The working group also proposed using video assessment of an MIS case to provide objective assessment of competency.
RESULTS: Case log data were available for 326 fellows with a total of 85,154 cases logged (median 227 per fellow). Based on these data, the working group proposed new criteria starting with minimum case volumes for five defined categories including foregut (20), bariatrics (25), inguinal hernia (10), ventral hernia (10), and solid organ/colon/thoracic (10). Fellows are also expected to perform an additional 75 complex MIS cases of any category for a total of 150 required cases overall. The proposal also included a minimum volume of flexible endoscopy (50) and submission of an MIS foregut case for video assessment. The new criteria more clearly defined which surgeon roles (i.e. teaching assistant, primary surgeon, first assistant) count for major credit within individual categories. Fourteen fellowships volunteered to pilot these new criteria for the 2017-18 academic year.
CONCLUSIONS: The new SAGES Advanced GI/MIS fellowship has been crafted to better define the core content that should be contained in these fellowships, while still allowing sufficient heterogeneity so that individual learners can tailor their training to specific areas of interest. The criteria also introduce innovative, evidence-based methods for assessing competency. Pending the results of the pilot program, SAGES will consider broad implementation of the new fellowship criteria.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86579
Program Number: S103
Presentation Session: Diversity and Innovation Session
Presentation Type: Podium