Objective The prevalence of robotic surgery has grown exponentially since its U.S. Food and Drug Administration (FDA) approval in 2000. This shift in technology has raised questions about the impact on surgery resident training. There is concern that increased utilization of robotic surgery may result in deficiency in laparoscopic training. The aim of this study was to assess the recent impact of robotic surgery on general surgery resident training. Design We performed a 2-phase study consisting of a retrospective review of institutional operative volume and a cross-sectional survey of current residents and alumni. A retrospective review of operative cases using the electronic medical record from 2015 to 2021 was performed to assess trends in common core minimally invasive surgical procedures. Following this, a quantitative, anonymous survey was sent to former and current general surgery residents who graduated after 2015. Setting A mid-sized, university-affiliated academic general surgery residency program with 6 to 8 categorical residents per year. Participants Operative case data from all minimally invasive general surgery procedures performed at the institution between 2015 and 2021 were analyzed. An anonymous electronic survey was distributed to general surgery alumni (graduation years 2015-2022) and current residents (clinical years 2023-2028 cohort). A total of 75 residents were invited to participate. Results From 2015 to 2021, 1436 robotic and 5504 laparoscopic surgeries were performed. There was a nearly 6-fold increase in robotic surgery over the study period. By 2021, both robotic ventral hernia repair and inguinal hernia repair volumes exceeded laparoscopic equivalents. Survey response rates were completed by 28/33 (85%) former alumni and 23/42 (55%) current residents. Majority of alumni (89.3%) reported good or excellent laparoscopic training experience compared with 39.1% of current residents. Most alumni and current residents reported good or excellent robotic training experience (67.9% and 82.6%, respectively). While nearly all alumni felt robotic surgery did not negatively impact laparoscopic training, 59.1% of current residents reported that robotic surgery has impeded their laparoscopic skill development. Conclusions Robotic surgery is increasing exponentially while laparoscopic surgical procedures have begun to decline. Residents may continue to perceive their laparoscopic experience as less robust than their robotic experience. Given the prolonged learning curve in laparoscopic surgery, it may be necessary to establish specific, defined minimum case requirements for laparoscopic surgery that are independent of robotic surgery.
BACKGROUND The COVID-19 pandemic prompted a shift to virtual residency interviews, although approximately half of integrated vascular surgery residency (VSR) programs have since returned to an in-person format. Amidst this evolving landscape, program websites have remained an invaluable resource for candidates to learn about VSR programs. In this study, we examined whether VSR program websites provide adequate and current information for residency candidates. METHODS A list of all active VSR programs was obtained from the Association of American Medical Colleges (AAMC) Electronic Residency Application Service (ERAS) website. Each program's website was reviewed in November 2025, and data were collected regarding program structure, faculty and current resident rosters, application requirements, and publicly available formal policies. RESULTS Of the 81 active programs, 80 (98.8%) had a formal residency program website. Information on residency program structure was reported in the majority of websites, including mission statement (91.4%), rotation and curriculum data (65.4%), rotating sites (61.7%), educational conferences (64.2%), and resident research experience (56.8%). Only ten programs (12.3%) reported resident operative volumes. Information regarding the residency program director (PD; 91.4%), program coordinator (PC; 92.6%), teaching faculty (92.6%), and current residents (81.5%) was available in most websites. However, with the exception of the PC (91.4%), contact information for the PD (40.7%), faculty (29.6%), and residents (13.6%) was not easily accessible. The majority of websites had a "how to apply" section (86.4%), but relatively few reported their interview dates (30.9%). Resident experience videos were available in less than half of websites (39.5%). Data on salary (53.1%), resident benefits (53.1%), vacation policies (27.2%), and academic conference policies (28.4%) were also inconsistently reported. CONCLUSIONS Residency program websites remain a central resource for applicants, particularly in the current era of virtual and hybrid interview formats. In this study, we found substantial variability in the information presented across VSR program websites, with a notable lack of accessible contact information for program leadership, faculty, and residents. Enhancing website content and transparency may better support applicants as they evaluate programs and prepare for the residency application process.
OBJECTIVE: The American Board of Surgery (ABS) implemented Entrustable Professional Activities (EPAs) to facilitate transition to competency-based resident assessments in July 2023. To improve faculty engagement, our institution established an intervention with a required target of less than 25% expired faculty EPA assessments for the 2024 to 2025 academic year (AY) to qualify for a shortened end-of-rotation resident evaluation form. DESIGN: A retrospective review of de-identified institutional EPA data for the AYs 2023 to 2024, preintervention, and 2024 to 2025, postintervention, obtained from the ABS website was conducted. Faculty rater, division, activity name, phase of care, entrustability score, and narrative feedback were analyzed. Descriptive statistics were employed to assess EPA assessment volume, number of faculty raters and evaluations by division, expired assessments, and details by postgraduate training year (PGY). Chi-Square, 2-proportion z-tests, and paired ttests were employed to compare pre and postintervention EPA assessment completion and qualities. SETTING: Affiliate hospitals of the Medical College of Wisconsin including Froedtert Hospital, a tertiary referral center in Milwaukee; Clement J. Zablocki Veteran's Affairs Hospital; and 3 community hospitals in the Milwaukee area. PARTICIPANTS: De-identified data from general surgery residents and faculty who completed any EPA assessment in AYs 2023 to 2024 and 2024 to 2025 were included. RESULTS: A total of 1111 and 1464 EPA assessments were completed for the 2023 to 2024 and 2024 to 2025 AYs, respectively, yielding a 1.32-fold increase post- intervention. There was a 1.27-fold increase in participating faculty raters (63 vs 80). Meaningful narrative feedback increased from 53.3% to 57.8% (p = 0.02). Of 11 service rotations with participating faculty raters, 5 met the <25% EPA assessment expiration metric in 2023 to 2024, compared to 8 in 2024 to 2025. The overall EPA assessment expiration rate decreased from 40.0% pre-intervention to 13.9% postintervention (p < 0.001). CONCLUSIONS: Incentivizing faculty to improve upon expired EPA assessments using a shortened end-of-rotation resident evaluation form increased EPA assessment completion, improved narrative feedback quality, and decreased expired EPA assessments. Initiatives to motivate faculty and residents to engage in timely and high-quality feedback will aid the ongoing transition to competency-based surgical education.
Objective Exposure to plastic and reconstructive surgery is critical for general surgery residents to develop interest in pursuing plastic surgery as a career. This study aims to quantify trends in exposure to plastic surgery among general surgery residents and exposures relationship to pursuing independent plastic and reconstructive surgery match. Design This was a retrospective cross sectional observational study using publicly available data and program correspondence. Setting Data on program curriculum and rotation schedules were collected from general surgery program websites and communication with general surgery program coordinators (maximum 3 attempts). Participants In total, 416 general surgery graduates from 341 programs from 2016 to 2024 were included in this study. Results General surgery programs with more exposure to plastic surgery through dedicated rotations produced more independent plastic surgery residents, with programs producing only 1 matched applicant found to have 1.84 months of exposure, compared to programs with 4+ matched applicants averaging 2.48 months of exposure (p-value = <0.0001). Furthermore, affiliation of a general surgery program with an independent plastic surgery program was more strongly associated with successful applicant matching than affiliation with an integrated plastic surgery program. Conclusions GS residencies with an affiliated independent PRS program are more likely to match interested residents into PRS than those without. There is not a similar benefit for GS programs affiliated with integrated programs alone. Exposure to PRS through dedicated rotations is positively associated with increasing matched applicants following GS residency.
Background Medical students often face limited involvement in robotic surgery, leading to unfulfilling learning experiences. Establishing a defined role for students in the operating room (OR) can enhance their engagement and deepen their understanding of robotic surgery. We describe the design and implementation of a curriculum designed to train medical students as robotic surgery bedside assistants and explore the perspectives of key stakeholders involved in the program. Methods We designed a curriculum based on Kern’s 6-step approach for curricular development. It included a series of online modules and a simulated hands-on session, followed by case assignments over their 4-week rotation. The curriculum centered on training students in an asset of core bedside skills that had been identified in a previous study. Students initially received supervision in the OR and progressed toward increasing autonomy. Fourth-year medical students could participate during their surgical subinternships. Major stakeholders, including students, residents, faculty, and OR staff participated in semistructured interviews to share their experiences; transcripts were subsequently analyzed using qualitative methods. Results Fourteen students participated and were interviewed. Students valued their defined roles, experiential learning, and interprofessional collaboration, noting increased engagement and confidence. Stakeholders (n = 13) reported that the curriculum enhanced medical student readiness for surgical training by fostering technical skill development, professional integration, and increased autonomy. Residents and faculty observed that students functioned at or near intern level by the end of the rotation and appreciated how student involvement at the bedside supported resident console time. OR staff and faculty acknowledged early implementation challenges, including staff unfamiliarity, but noted that improved communication and onboarding processes helped address these barriers. Conclusions The robotic bedside assist curriculum was perceived to support safe, structured, and inclusive learning while promoting student development within the surgical team, giving students a legitimate role in robotic surgery.
