Am I Cut Out for This? Transitioning From Surgical Trainee to Attending

Montbrun, Sandra de; Patel, Priyanka; Mobilio, Melanie Hammond; Moulton, Carol‐Anne

doi:10.1016/j.jsurg.2017.09.034

Cited by 19 publications

(26 citation statements)

References 20 publications

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“…Years of post-training experience of the attending surgeon were also documented. Due to previous studies describing the first 5 years of an attending's career as critical years of experience which may serve as a division into junior and more senior attendings, [7][8][9] attending surgeons were grouped into those with ≤5 years of experience or >5 years of experience. There were 10 surgeons at this institution who regularly perform cholecystectomies through an equally distributed rotation of general surgery services and call.…”

Section: Methodsmentioning

confidence: 99%

“…The primary aim of this study was to determine if provider experience is associated with the performance of subtotal cholecystectomy. Since the first 5 years are considered early in an attending's career, [7][8][9] we hypothesized that surgeons with ≤5 years of attending experience would be more likely to perform a subtotal cholecystectomy than would attending surgeons with >5 years of experience. Secondary outcomes included examination of patient factors associated with subtotal cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%

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Factors that Predict the Need for Subtotal Cholecystectomy

Tang

Cohan

Beattie

et al. 2020

The American Surgeon™

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Background Subtotal cholecystectomy is a “damage control” or “bailout procedure” that is used in difficult gallbladder cases when severe inflammation distorts the local anatomy resulting in increased risk in damage to surrounding structures. Subtotal cholecystectomy rates increased nationally over the past decade. We aimed to determine provider experience and patient factors associated with the performance of subtotal cholecystectomies. Methods All cholecystectomies from 2016 to 2019 were reviewed. Patient demographics, laboratory values, imaging, preoperative diagnosis, surgical technique (fenestrating vs. reconstituting), and years of attending and resident experience were collected. Multivariable regression analysis was performed to evaluate for factors that increase the likelihood of subtotal cholecystectomy. Results Of 916 cholecystectomies, 86 were subtotal. The likelihood of subtotal cholecystectomy did not increase based on attending experience of ≤5 vs. > 5 years (odds ratio (OR) .66, P = .09). Older age (adjusted odds ratio (aOR) 1.23, P = .03), male sex (aOR 2.59, P < .01), white blood cells (WBC) above 10.3 (aOR 2.02, P = .02), and preoperative diagnosis of acute on chronic cholecystitis (aOR 5.47, P < .01) were associated with increased likelihood of subtotal cholecystectomy. Discussion Older age, male sex, WBC above 10.3, and preoperative diagnosis of acute on chronic cholecystitis were associated with the increased likelihood of subtotal cholecystectomies. The performance of subtotal cholecystectomy was not impacted by attending years of experience. In cases of severe gallbladder pathology, this technique is being used as an operative strategy among all surgeon levels.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors that Predict the Need for Subtotal Cholecystectomy

Tang

Cohan

Beattie

et al. 2020

The American Surgeon™

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“…Similarly, physicians often feel obligated to portray an image of certainty, confidence and bravery, masking feelings of stress and vulnerability (Arora et al 2009; Orri, Revah-Lévy, and Farges 2015; Patel et al 2018). Reputation can be a source of anxiety, especially for early-career and late-career physicians (Leung et al 2012; Montbrun et al 2018). Physicians early in their careers may experience stress as they build up their reputations to secure patient referrals, and therefore may be more anxious about how they are viewed by their colleagues.…”

Section: Classic Unidimensional Operationalisations Of Stressmentioning

confidence: 99%

Pulling our lens backwards to move forward: an integrated approach to physician distress

2021

Self Cite

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The medical community has recently acknowledged physician stress as a leading issue for individual wellness and healthcare system functioning. Unprecedented levels of stress contribute to physician burnout, leaves of absence and early retirement. Although recommendations have been made, we continue to struggle with addressing stress. One challenge is a lack of a shared definition for what we mean by ‘stress’, which is a complex and idiosyncratic phenomenon that may be examined from a myriad of angles. As such, research on stress has traditionally taken a reductionist approach, parsing out one aspect to investigate, such as stress physiology. In the medical domain, we have traditionally underappreciated other dimensions of stress, including emotion and the role of the environmental and sociocultural context in which providers are embedded. Taking a complementary, holistic approach to stress and focusing on the composite, subjective individual experience may provide a deeper understanding of the phenomenon and help to illuminate paths towards wellness. In this review article, we first examine contributions from unidimensional approaches to stress, and then outline a complementary, integrated approach. We describe how complex phenomena have been tackled in other domains and discuss how holistic theory and the humanities may help in studying and addressing physician stress, with the ultimate goal of improving physician well-being and consequently patient care.

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“…New staff often wrestles with training residents, an unfamiliar workplace, managing multiple tasks, billing, and undergoing an identity transformation. 50 Both young and senior surgeons agree that there is a lack in training with finance, compensation, coding and billing, interpersonal skills, ethics, and professionalism, which are necessary for a successful transition. 51 Emphasis on these transition periods has occurred at the Surgeons, Scholars, and Leaders Symposium.…”

Section: Career Development and Managing Transitionsmentioning

confidence: 99%

Surgeons, Scholars, and Leaders Symposium: A 5-Year Experience

Morris

Baker

Edwards

2019

The American Surgeon™

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The Department of Surgery at the University of Cincinnati developed the Surgeons, Scholars, and Leaders Symposium to address the underappreciated aspects of surgical education that are critical in the development of the academic surgeon. Surgical education has undergone many gaps since the beginning of a traditional surgical residency, first pioneered by Dr. Halsted in 1904; still, many gaps in surgical education remain. Topics such as research, financial planning, leadership, career development, and many others are not adequately addressed in formalized training. The Surgeons, Scholars, and Leaders Symposium was first held in January 2015 in Jackson Hole, WY, and has subsequently become an annual event. Recurrent themes addressed at the Symposium include global health, resident autonomy, research program development, leadership, mentorship, career development, and managing transitions. The annual Surgeons, Scholars, and Leaders Symposium has been instrumental in addressing these underappreciated aspects of surgeon development and will continue to be an important venue for the next generation of surgical leaders.

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Am I Cut Out for This? Transitioning From Surgical Trainee to Attending

Cited by 19 publications

References 20 publications

Factors that Predict the Need for Subtotal Cholecystectomy

Factors that Predict the Need for Subtotal Cholecystectomy

Pulling our lens backwards to move forward: an integrated approach to physician distress

Surgeons, Scholars, and Leaders Symposium: A 5-Year Experience

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