• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Mastery of General Surgery: An Impossible Task In The Army Healthcare System

Timothy P Plackett, DO, MPH1, Joel R Brockmeyer, MD2, Danielle B Holt, MD3, Robert M Rush, Jr, MD4, Joy Sarkar, MD5, Steven A Satterly, MD1, Jason M Seery, MD6, Bradley R Zagol, MD7. 1Womack Army Medical Center, 2Eisenhower Army Medical Center, 3Walter Reed National Military Medical Center, 4Madigan Army Medical Center, 5Brian Allgood Army Community Hospitl, 6Martin Army Community Hospital, 7Augusta University Medical Center

Objectives: The primary objective is to quantify the operative experience of Army general surgeons while not deployed and determine their capacity to obtain mastery in the operating room while working at military hospitals.  The secondary objective is to determine the effect of rank and individual hospitals on operative experience.

Methods: Average Surgeon Time reports were generated from the Surgical Scheduling System for all general surgery cases performed at seven Army medical treatment facilities (MTFs) during 2012-2016.  Cases performed by non-general surgeons were excluded.  Data was analyzed using the apriori definition of 10,000 hours of operative time equating with mastery.  This definition is based upon Ericsson’s Deliberate Practice Model and popularized by Malcolm Gladwell.  Groups were compared using a one-way ANOVA.

Results: 122 general surgeons operated at the 7 MTFs during the study period.  14 of the general surgeons were civilian employees and 6 surgeons were backfills with their primary MTF not participating in the study; these 20 surgeons were excluded from further analysis.  The average surgeon performed 108 ± 68 cases per year while in garrison.  The average surgeon spent 124 ± 86 hours operating annually while in garrison.  At this rate, it would take over 80 years to obtain mastery of surgery.  The ten highest volume surgeons averaged 218 cases per year and 291 hours of operating annual.  For the ten highest volume surgeons, it would take 34 years to obtain mastery of surgery.

When stratified based upon rank, Majors averaged 102 ± 51 cases and 114 ± 76 hours of surgery per year, Lieutenant Colonels averaged 137 ± 65 cases and 168 ± 100 hours of surgery per year, and Colonels averaged 107 ± 87 cases and 136 ± 101 hours of surgery per year.  Only the difference between Majors and Lieutenant Colonels was statistically significant (p<0.01).

When stratified based upon individual hospital there was significant variance in case volume and hours of surgery per year between the facilities (p<0.05).  At the highest performing hospital surgeons averaged 170 ± 83 cases and 187 ± 103 minutes of surgery per year.   At the lowest performing hospital surgeons averaged 71 ± 49 cases and 85 ± 56 minutes of surgery per year.

Conclusions: Obtaining mastery of general surgery is a nearly impossible proposition given the current care models at Army MTFs.  Alternative staffing and patient care models should be developed if Army surgeons are to be masters at their craft.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86443

Program Number: MSS20

Presentation Session: Full-Day Military Surgical Symposium – General Surgery Presentations

Presentation Type: MSSPodium

102

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2018 abstract archive

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
sagesweb@sages.org
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons