Defining the Surgical Oncology Experience during General Surgery Residency: A Multi-Institutional Study from the US ROPE Consortium.

BACKGROUND

Surgical oncology operative experience during general surgery residency is poorly characterized. We hypothesized that graduates pursuing the Complex General Surgical Oncology (CGSO) fellowship would have greater surgical oncology exposure and log more surgical oncology relevant (SOR) cases.

PATIENTS AND

METHODS

Demographics, program characteristics, and Accreditation Council for Graduate Medical Education (ACGME) case logs were collected from 20 general surgery residency programs in the US Resident OPerative Experience (ROPE) Consortium spanning 2010-2020. CGSO matriculants (CGSO group) were compared with graduates entering other surgical fellowships/practice (non-CGSO group). SOR cases included liver, pancreas, breast, endocrine, laparoscopic colorectal, and abdominoperineal resection.

RESULTS

Among 1343 graduates, 80 (6%) pursued CGSO fellowships. Demographics, including sex, race/ethnicity, and underrepresented in medicine, were similar between groups (all p > 0.05). CGSO matriculants more often graduated from university-based programs with CGSO-trained faculty (95% vs 86%), dedicated surgical oncology divisions (81% vs 66%), and National Cancer Institute (NCI)-designated Cancer Centers (85% vs 68%, all p < 0.05). Median total cases were similar between groups; however, CGSO-bound graduates logged greater SOR procedures (162 vs 141), including liver (+4), pancreas (+10), endocrine (+7), and laparoscopic colorectal (+5, all p < 0.05). In multivariable analysis, factors associated with CGSO matriculation included departmental NIH funding (OR 4.82, 95% CI 1.18-19.79, p = 0.02), dedicated research experience (OR 5.62, 95% CI 3.02-10.44, p < 0.001), and increased SOR cases (OR 1.01, 95% CI 1.001-1.01, p = 0.02).

CONCLUSIONS

CGSO matriculants have a unique general surgery training experience and log more SOR cases, which could reflect efforts to prepare for fellowship and/or the influence of surgical oncology immersion on career interest. These data highlight opportunities to bolster CGSO recruitment and fellowship preparation.