A Comparative Study of Contrasting Surgical Residency Programs

Postgraduate training is completed in a 5-year surgical residency program in the USA, compared with 10 years in the UK. The UK Joint Committee on Surgical Training (JCST) has described quality indicators for surgical training. Similar indicators can be inferred from the American Board of Surgery and Accreditation Council for Graduate Medical Education. This exploratory study compares postgraduate surgical training between two regions following their respective national programs. A questionnaire was developed based on JCST quality indicators. This was distributed electronically to all general surgical residents in the University of Pennsylvania (UPenn) (N = 64) and North and South West Thames general surgical registrars in London (N = 182). A total of 76 residents (31 %) completed the questionnaire and all data presented are self-reported. When residents operate electively, an attending is scrubbed for 57 % of cases in London versus 83 % at UPenn (p < 0.001). During emergency surgery, residents operate without an attending in the operating room (OR) for 60 % of cases in London versus 2 % in UPenn (p < 0.001). London versus UPenn residents have a mean 3.6 versus 5.0 (p < 0.001) operating sessions and 0.7 versus 2.3 (p < 0.001) teaching hours per week. In London, 68 % of residents have regular gastrointestinal endoscopy sessions compared with 39 % at UPenn (p = 0.036). UPenn residents receive more supervised operating opportunities and scheduled teaching than their London counterparts. However, they have less independent operating experience and less exposure to gastrointestinal endoscopy training.