BOOK
Development of a Surgeon: Medical School through Retirement, An Issue of Surgical Clinics of North America, E-Book
Ronald F. Martin | Paul J. Schenarts
(2016)
Additional Information
Book Details
Abstract
This issue of Surgical Clinics of North America, guest edited by Drs. Ronald Martin and Paul Schenarts, is devoted to Development of a Surgeon: Medical School through Retirement. They have assembled expert authors to review the following topics: Residency Surgical Training at a University Academic Medical Center; Fellowship Training: Need and Contributions; Evolving Educational Techniques in Surgical Training; Transition to Practice: From Trainee to Staff Surgeon; The Value of the Surgeon Emeritus; Alternative Methods and Funding for Surgical Training; Medical School Training for the Surgeon; Residency Surgical Training at an Independent Academic Medical Center; Assessment of Competence: The ACGME/RRC Perspective; Assessment of Competence: The American Board of Surgery Perspective; The Impaired Surgeon; Continuing Medical Education: The American College of Surgeons Perspective; Workforce Needs and Demands in Surgery, and more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Development of a Surgeon: Medical Schoolthrough \rRetirement | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword\r | vii | ||
| Preface: Development of a Surgeon\r | vii | ||
| Medical School Training for the Surgeon\x0B | vii | ||
| Assessment of Competence: The Accreditation Council for Graduate Medical Education/Residency Review Committee Perspective\r | vii | ||
| Transition from Training to Surgical Practice\r | vii | ||
| Alternative Considerations for Surgical Training and Funding\r | viii | ||
| Fellowship Training: Need and Contributions\x0B | viii | ||
| Surgical Residency Training at a University-Based Academic Medical Center\r | viii | ||
| Evolving Educational Techniques in Surgical Training\r | viii | ||
| The Impaired Surgeon\r | ix | ||
| Workforce Needs and Demands in Surgery\r | ix | ||
| Education and Training to Address Specific Needs During the Career Progression of Surgeons\r | ix | ||
| The Aging Surgeon: Implications for the Workforce, the Surgeon, and the Patient\r | ix | ||
| Forks in the Road: The Assessment of Surgeons from the American Board of Surgery Perspective\r | x | ||
| Residency Surgical Training at an Independent Academic Medical Center\r | x | ||
| SURGICAL CLINICS\rOF NORTH AMERICA\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| April 2016 | xi | ||
| June 2016 | xi | ||
| August 2016 | xi | ||
| RECENT ISSUES | xi | ||
| December 2015 | xi | ||
| October 2015 | xi | ||
| August 2015 | xi | ||
| June 2015 | xi | ||
| Foreword | xiii | ||
| Preface: Development of a Surgeon \r | xv | ||
| Medical School Training for the Surgeon | 1 | ||
| Key points | 1 | ||
| SURGERY TRAINING IN THE TRADITIONAL MEDICAL SCHOOL CURRICULUM | 2 | ||
| ENTRUSTABLE PROFESSIONAL ACTIVITIES | 2 | ||
| IMPACT ON CAREER CHOICE AND RETENTION IN GENERAL SURGERY | 3 | ||
| FOURTH YEAR PREPARATORY COURSES: SURGERY “BOOT CAMP” | 4 | ||
| MOVING TOWARD A COMMON PREPARATORY CURRICULUM: IDENTIFYING CORE ELEMENTS | 5 | ||
| Mock Paging Programs | 6 | ||
| Interactive Patient Care Scenarios | 6 | ||
| Technical Skills Training | 7 | ||
| VISION FOR THE FUTURE: INTEGRATING LONGITUDINAL EFFORTS THROUGHOUT MEDICAL SCHOOL | 7 | ||
| SUMMARY | 11 | ||
| REFERENCES | 11 | ||
| Assessment of Competence | 15 | ||
| Key points | 15 | ||
| THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION COMPETENCIES | 15 | ||
| Patient Care | 15 | ||
| Medical Knowledge | 16 | ||
| Practice-Based Learning and Improvement | 16 | ||
| Interpersonal and Communication Skills | 16 | ||
| Professionalism | 16 | ||
| Systems-Based Practice | 16 | ||
| Limitations | 17 | ||
| COMPETENCE | 17 | ||
| THE EDUCATIONAL ENVIRONMENT | 18 | ||
| Federal Regulation | 18 | ||
| The Accreditation Council for Graduate Medical Education Outcomes Project | 18 | ||
| Milestones | 18 | ||
| The Next Accreditation System | 19 | ||
| The Clinical Learning Environment Review | 19 | ||
| COMPETENCY-BASED RESIDENCY EDUCATION | 20 | ||
| Regulatory Obstacles | 20 | ||
| Competency-Based Curricula | 21 | ||
| Local Barriers | 21 | ||
| Accreditation Council for Graduate Medical Education Facilitation of Competency-Based Residency Education | 22 | ||
| SUMMARY | 23 | ||
| REFERENCES | 23 | ||
| Transition from Training to Surgical Practice | 25 | ||
| Key points | 25 | ||
| INTRODUCTION | 25 | ||
| ARE CURRENT RESIDENCY GRADUATES READY FOR SURGICAL PRACTICE? | 26 | ||
| INSTITUTIONAL METHODS USED FOR TRANSITION FROM TRAINING TO SURGICAL PRACTICE | 27 | ||
| THE AMERICAN COLLEGE OF SURGEONS TRANSITION TO PRACTICE GENERAL SURGERY PROGRAM | 29 | ||
| FUTURE PREPARATION FOR SURGICAL PRACTICE | 29 | ||
| REFERENCES | 32 | ||
| Alternative Considerations for Surgical Training and Funding | 35 | ||
| Key points | 35 | ||
| INTRODUCTION | 35 | ||
| DISCLAIMERS | 36 | ||
| FURTHER DISCLAIMER AND EDITORIAL NOTE | 36 | ||
| CURRENT STATUS | 37 | ||
| ALTERNATIVE FUNDING STRATEGIES | 38 | ||
| Training Costs | 38 | ||
| Cost of Graduate Medical Education As a Function of the Larger Economy | 39 | ||
| Resident Training As a Commodity | 39 | ||
| CERTIFICATION DRIVES TRAINING MODELS | 41 | ||
| LENGTH OF TRAINING FOR GENERAL SURGERY | 43 | ||
| DO AWAY WITH RESIDENCY TRAINING AS WE KNOW IT | 44 | ||
| SUMMARY | 46 | ||
| REFERENCES | 46 | ||
| Fellowship Training | 47 | ||
| Key points | 47 | ||
| HISTORICAL REVIEW | 47 | ||
| FACTORS CONTRIBUTING TO THE NEED FOR FELLOWSHIP TRAINING | 49 | ||
| FELLOWSHIP TRAINING, THEN AND NOW | 51 | ||
| CURRENT STATUS OF SURGICAL FELLOWSHIPS AND SUBSPECIALTIES | 53 | ||
| REFERENCES | 56 | ||
| Surgical Residency Training at a University-Based Academic Medical Center | 59 | ||
| Key points | 59 | ||
| PREPARING RESIDENTS TO ENTER THE SURGICAL WORKFORCE | 60 | ||
| SURGICAL SCHOLARSHIP | 62 | ||
| THE MULTIGENERATIONAL WORKFORCE | 63 | ||
| GLOBAL SURGERY | 65 | ||
| FUNDING FOR GRADUATE MEDICAL EDUCATION | 66 | ||
| ASSESSING THE QUALITY OF GRADUATE MEDICAL EDUCATION | 66 | ||
| BARRIERS AND CHALLENGES | 67 | ||
| SUMMARY | 67 | ||
| REFERENCES | 68 | ||
| Evolving Educational Techniques in Surgical Training | 71 | ||
| Key points | 71 | ||
| INTRODUCTION | 71 | ||
| HISTORY | 72 | ||
| CATALYST FOR CHANGE | 73 | ||
| Shifting Medical Environment | 73 | ||
| A Different Medical Learner | 74 | ||
| EVOLVING TECHNIQUES IN SURGICAL EDUCATION | 75 | ||
| Defining E-learning | 75 | ||
| Flipped Versus Blended Classroom Versus Massive Open Online Courses | 76 | ||
| Online Surgical Resources | 78 | ||
| Social Media | 79 | ||
| Simulation | 79 | ||
| Robotics | 80 | ||
| Telesurgery | 81 | ||
| Animate Models | 81 | ||
| Gaming | 81 | ||
| CHALLENGES OF INNOVATION IN SURGICAL EDUCATION | 82 | ||
| SUMMARY | 83 | ||
| REFERENCES | 84 | ||
| The Impaired Surgeon | 89 | ||
| Key points | 89 | ||
| BACKGROUND | 89 | ||
| Prevalence | 90 | ||
| Impairment Is Treatable | 90 | ||
| IDENTIFYING AN IMPAIRED PHYSICIAN | 91 | ||
| INTERVENING WITH AN IMPAIRED PHYSICIAN | 91 | ||
| OUTCOMES | 92 | ||
| SUMMARY | 92 | ||
| REFERENCES | 93 | ||
| Workforce Needs and Demands in Surgery | 95 | ||
| Key points | 95 | ||
| INTRODUCTION | 95 | ||
| DEFINITIONS AND DYNAMICS OF SURGICAL WORKFORCE AND OVERVIEW OF CURRENT TRENDS AND ISSUES | 97 | ||
| Current Workforce Data | 97 | ||
| Change in Workforce Numbers | 97 | ||
| Distribution of the Surgical Workforce in the United States | 97 | ||
| Number of Some of the Common General Surgical Procedures Performed in the United States | 99 | ||
| Population Growth in the United States | 99 | ||
| Pipeline for Training General Surgeons | 99 | ||
| CURRENT MODEL OF TRAINING FROM MEDICAL SCHOOL TO PRACTICE WITH SOME SUGGESTED CHANGES TO THE TRAINING SYSTEMS OF TODAY TO A ... | 102 | ||
| Medical School | 104 | ||
| Early exposure of medical students to the field of general surgery | 104 | ||
| Dispel negative perceptions about general surgery/improve clerkship experience | 105 | ||
| Role models | 105 | ||
| Highlight lifestyle issues | 105 | ||
| Strategic targeting of residents | 106 | ||
| International medical graduates | 106 | ||
| Surgical Residency | 107 | ||
| Change perceptions about general surgery | 107 | ||
| General surgery is a high-priority specialty | 107 | ||
| Appraisal of location of surgery residency programs | 108 | ||
| Tackling duty hour regulations | 108 | ||
| Gender-friendly environment in surgical residency | 108 | ||
| Progression during residency based on assessment and testing in written, oral, and technical skills after graduation | 109 | ||
| Shorter training period/absorb training practices from other parts of the world | 109 | ||
| System should be rapidly adaptable to new diseases and technology | 110 | ||
| Promote global health rotations | 110 | ||
| Target attrition | 110 | ||
| Lobbying to increase the number of residency positions | 110 | ||
| REFERENCES | 110 | ||
| Education and Training to Address Specific Needs During the Career Progression of Surgeons | 115 | ||
| Key points | 115 | ||
| BACKGROUND | 115 | ||
| THE NEW PARADIGM OF CONTINUOUS PROFESSIONAL DEVELOPMENT AND PRACTICE-BASED LEARNING AND IMPROVEMENT | 116 | ||
| FOCUS ON MAINTENANCE OF CERTIFICATION AND MAINTENANCE OF LICENSURE | 118 | ||
| FOCUS ON CRITICAL TRANSITIONS DURING THE CAREER PROGRESSION OF PRACTICING SURGEONS | 119 | ||
| Entry into Practice | 119 | ||
| The Core Period of Professional Practice | 121 | ||
| Professional Activities During the Later Years | 125 | ||
| SUMMARY | 126 | ||
| REFERENCES | 126 | ||
| The Aging Surgeon | 129 | ||
| Key points | 129 | ||
| THE AGING OF THE SURGICAL WORKFORCE | 130 | ||
| SURGEONS AND RETIREMENT | 130 | ||
| PHYSIOLOGIC CHANGES OF THE AGING SURGEON | 131 | ||
| Decline in Cognition and Neuromuscular Function | 131 | ||
| Sensory Impairment | 132 | ||
| Impact of Prolonged Physical and Psychological Stress | 132 | ||
| Psychiatric Illness | 133 | ||
| Neurocognitive Testing | 133 | ||
| DIFFICULTY TEACHING “OLD DOGS NEW TRICKS” | 133 | ||
| THE GREAT PARADOX OF THE AGING SURGEON: GREATER EXPERIENCE BUT WORSE CLINICAL PERFORMANCE | 134 | ||
| ASSURING COMPETENCY AND PHYSICAL AND MENTAL CAPABILITIES | 134 | ||
| Why Problem Surgeons Are Not Identified | 134 | ||
| Assuring Competent Care | 135 | ||
| Evaluating Physical and Mental Capabilities | 135 | ||
| Adaptive Strategies | 135 | ||
| UTILIZING THE AGING SURGEON | 136 | ||
| REFERENCES | 136 | ||
| Forks in the Road | 139 | ||
| Key points | 139 | ||
| HISTORY | 140 | ||
| TIME-LIMITED CERTIFICATES AND RECERTIFICATION | 140 | ||
| MAINTENANCE OF CERTIFICATION | 142 | ||
| PREPARATION FOR RESIDENCY | 143 | ||
| SURGICAL RESIDENCY | 144 | ||
| RE-ENTRY TO CLINICAL PRACTICE | 145 | ||
| SUMMARY | 145 | ||
| REFERENCES | 145 | ||
| Residency Surgical Training at an Independent Academic Medical Center | 147 | ||
| Key points | 147 | ||
| INTRODUCTION | 147 | ||
| HISTORY | 148 | ||
| ADVANTAGES | 148 | ||
| CHALLENGES | 149 | ||
| RESIDENT RECRUITMENT | 150 | ||
| GRADUATE PERFORMANCE AND OUTCOMES | 151 | ||
| SUMMARY | 152 | ||
| REFERENCES | 152 | ||
| Index | 155 |