General Surgery Education in Latin America: the Residents’ Perspective. Initial experience in Colombia and Panama

Juan C Correa, MD1, Maryam Elmi, MD1, Alvaro E Sanabria, PhD, MD2, Carlos H Morales, MD, MsC3, Moises Cukier4, Frances C Wright, MEd, MD1, Jaime M Escallon1, Oscar Henao1. 1University of Toronto, 2Hospital Pablo Tobon Uribe, 3Universidad de Antioquia, 4National Cancer Institute, Panama

Background: This study was performed to identify the strengths and weaknesses perceived by Latin-American senior general surgery residents in their training.

Methods: A web-based survey was designed based on a previous experience in Canada, tested in a focus group and then was sent via e-mail to 158 Colombian and 14 Panamenian residents in their 2 final years of training (PGY 3-4 in Colombia, PGY 4-5 in Panama). Demographic information, career plans, academic interests and perceptions of their technical and academic knowledge.

Results: The response rate was 54% in Colombia (86/158) and 57% in Panama (8/14). 63.8% of respondents were Male and 36.2 female. 55.8% of respondents in Colombia were PGY3 and 50% were PGY 4 in Panama 50% were PGY4. 

When asked to rate their laparoscopic training 31.8% thought it was poor or below average, 19% as average and 48.9% as above average or excellent. 54.55% of Residents did not attend frequently a surgical skills laboratory (SSL) during their training.

94% of residents believe that strengthening surgical simulation programs should be a priority in order to improve general surgery education in their country.

When asked how often they would require assistance while performing a laparoscopic procedure as the primary surgeon: 65.5% requires assistance for a Laparoscopic Right Hemi-colectomy, 67.8% for a Nissen Funduplication, 50% for a Laparoscopic inguinal Hernia and 46.7% for a Laparoscopic Splenectomy. 

Residents felt comfortable as primary surgeons in over 90% of all Open Inguinal hernias, Laparoscopic appendectomies, Diagnostic Laparoscopies, Splenectomies and Open Right Hemicolectomies.

53.2% of Residents are interested in pursuing a fellowship. 98% of respondents are interested in an academic position and 83% want to continue performing research after their residency is finished.

Residents believe that doing research would always or frequently provide them with better job opportunities in 25% of opportunities, prestige in 51.1% and economic benefits in 6.82%

Conclusions: This study is a baseline to determine the educational objectives that residents feel should be met.  A great majority of residents want to work in an academic position, and do research, but most of them feel that this is not often recognized with better employment opportunities, salaries or prestige.

Over 54% of the residents don’t have frequent training in a SSL, and 31.8% thought their laparoscopic training needed improvement. Strengthening surgical simulation should be and educational priority.

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