Poisson Probability of Failing to Meet Minimum Case Volumes in Pediatric Surgery Fellowships
| Autor: | Eunice Y. Huang, Ankush Gosain, Donald J Lucas |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Graduate medical education Workload Certification Poisson distribution Pediatrics Accreditation 03 medical and health sciences symbols.namesake 0302 clinical medicine Specialty Boards Pediatric surgery Humans Medicine Operations management Poisson Distribution Significant risk Fellowships and Scholarships National data business.industry United States Report summary Education Medical Graduate General Surgery 030220 oncology & carcinogenesis symbols 030211 gastroenterology & hepatology Surgery business |
| Zdroj: | Annals of Surgery. 274:e289-e294 |
| ISSN: | 1528-1140 0003-4932 |
| DOI: | 10.1097/sla.0000000000003563 |
| Popis: | Introduction With the expansion of pediatric surgery fellowships from 2008 to 2018, there is concern for the dilution of training experience, especially for rare index cases. The Accreditation Council for Graduate Medical Education (ACGME) established required minimum case numbers by case type, but this is a program requirement rather than an individual trainee requirement. The American Board of Surgery (ABS) is considering instituting minimum case requirements across 5 broad categories for individuals to be board-eligible in pediatric surgery. Methods The ACGME National Data Report summary case logs were obtained for graduating fellows in pediatric surgery from 2008 to 2018. Median case volumes were compared to minimum ACGME case numbers and proposed ABS individual requirements. Using Poisson distributions, probabilities of individual fellows failing to meet minimum case numbers were calculated. Results The average annual probability that a median program would fail to meet minimum ACGME case numbers in at least 1 category was estimated at 16.6%. Using the proposed ABS system, the probability of failure was estimated at 44.1%. No temporal trend was found in the annual probability of failure in either the ACGME or the proposed ABS system. Conclusions There is significant risk of a fellow failing to meet case minimums in the ACGME system and the proposed ABS system. This probability is increased for the half of programs below median. If the ABS institutes case minimums as a requirement for certification in pediatric surgery, the current training paradigm may be impacted at some programs. |
| Databáze: | OpenAIRE |
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