The Association of VA Surgeons
AVAS Best Clinical Resident Award (Tied): Fate of non-designated preliminary general surgery residents seeking a categorical residency position

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Abstract

Background

As pyramidal programs in general surgery were eliminated in recent decades, nondesignated preliminary surgery (NDPS) positions were introduced to fill vacant positions. Graduating medical students can pursue NDPS positions with the goal of obtaining categorical positions in either general surgery residencies or other fields altogether. The fate of residents who complete 2 years as NDPS residents remains ill defined.

Methods

From 1997 to 2007, data concerning NDPS residents were prospectively collected from 2 general surgery training programs. Trainees were followed by prospectively gathered data, Internet identification, and internal records of hospital privileging.

Results

One hundred ten graduating medical students initiated postgraduate training as NDPS residents. Seventy-four (67%) were men, and 98 (89%) were international medical graduates. Among all 110 subjects, 95 (86%) were hired as postgraduate year 1 NDPS residents, and 15 (14%) were hired as postgraduate year 2 NDPS residents. Fifteen (14%) left postgraduate medical education. Fifty-two NDPS residents (47%) pursued nonsurgical specialties after their internships. Forty-three (39%) eventually matriculated as categorical general surgical residents. Of these, 20 (47%) became categorical residents in their initial training programs. Nearly all NDPS residents who proceed to categorical positions obtained board certification.

Conclusions

More than one third of NDPS residents successfully obtained categorical general surgery positions. Only a small fraction (14%) failed to continue in postgraduate medical education. NDPS positions allow most candidates successful career paths. The persistent rate of attrition among categorical surgical residents allows NDPS residents to join categorical training programs and become eligible for board certification in general surgery.

Section snippets

Methods

Data were gathered prospectively from July 1997 to June 2007. None of the subjects was a patient undergoing evaluation or treatment, and therefore the study population was not subject to approval from an internal institutional review board. The subjects were NDPS general surgery residents at the University of Connecticut Health Center and Yale-New Haven Hospital during the study period. Subjects were followed by prospectively maintained databases, personal communication, Internet

Results

One hundred ten subjects were identified as NDPS residents in the study period. Of these residents, 74 (67%) were men. Ninety-five (86%) enrolled at the postgraduate year 1 level, while 15 (14%) entered into their programs as postgraduate year 2 NDPS residents. Twelve (11%) were graduates of US medical schools. Ninety-eight (89%) were international medical graduates, of whom 64 (58% of the total study group) were graduates from either Indian or Pakistani medical schools (Table 1).

Upon

Discussion

This study characterizes the training paths of medical school graduates, both domestic and international, who enrolled as NDPS trainees at two university-based general surgery residency programs. In these two training programs, the NDPS positions serve two major purposes. The first purpose is to bridge the gaps in the junior-level house staff that were left by the conversion from pyramidal to rectangular training paradigms. Now, in the second decade since the elimination of the pyramidal

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The authors examined the career paths of nondesignated preliminary surgery residents at two university-based residency programs.

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