A Multi-institutional Study From the United States Resident Operative Experience Consortium Examining Factors Associated With Exposure and Pursuit of Colorectal Fellowship Following General Surgery Residency.

Abstract

Background: Colon and rectal surgery is a popular fellowship following general surgery residency. The impact of a resident's colon and rectal surgery experience during residency may impact their career trajectory and pursuit of colon and rectal surgery.

Objective: This study aims to identify individual and program factors associated with matriculation into colon and rectal surgery fellowship compared to other career trajectories.

Design: An analysis of case logs and demographic data from graduates of 19 accredited general surgery residency programs from the Accreditation Council for Graduate Medical Education between 2010-2020 was completed utilizing the United States Resident Operative Experience Consortium. The demographics and operative experience of residents who pursued colon and rectal surgery fellowship were compared to those who did not.

Settings: This study is a retrospective review of resident specialty selection, demographic information, and operative case logs.

Participants: Graduates of 19 accredited general surgery residency programs from the Accreditation Council for Graduate Medical Education between 2010-2020 participated in the study.

Main outcomes measures: Resident demographics, general and colon and rectal surgery-related program-specific characteristics, and resident operative case logs associated with entrance into colon and rectal surgery fellowship served as the primary outcome measures.

Results: Those in the colon and rectal surgery cohort were more likely to be female sex and have completed a dedicated research experience. No association was noted with co-location of a colon and rectal surgery fellowship and general surgery residency. Multivariable analysis demonstrated a higher likelihood of colon and rectal surgery fellowship matriculation for female sex residents and residents who completed a clinical fourth-year colon and rectal surgery rotation. Higher logged colon and rectal surgery-specific case volume was associated with those matriculating into colon and rectal surgery.

Limitations: Self-reported case log data, differences in residency structures in offering colon and rectal surgery rotations to clinical fourth-year residents, academic bias of participating residency programs.

Conclusions: This study identified individual and program-specific factors associated with matriculating into colon and rectal surgery fellowship, such factors include female sex, colon and rectal surgery-specific rotation in the fourth clinical year, and higher volume of colon and rectal surgery-specific cases. These data may optimize resident colon and rectal surgery experience and strengthen the colon and rectal surgery fellowship pipeline. See Video Abstract.