Development of a surgeon: medical school through retirement
Gespeichert in:
| Weitere Verfasser: | , |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pennsylvania
Elsevier
[2016]
|
| Schriftenreihe: | Surgical clinics of North America
volume 96, number 1 (February 2016) |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | xvi, 162 Seiten Illustrationen |
| ISBN: | 9780323417143 |
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| 245 | 1 | 0 | |a Development of a surgeon |b medical school through retirement |c editors Ronald F. Martin, Paul J. Schenarts |
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| 700 | 1 | |a Martin, Ronald F. |0 (DE-588)1081228199 |4 edt | |
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| adam_text | Titel: Development of a surgeon
Autor: Martin, Ronald F
Jahr: 2016
Development of a Surgeon: Medical School through Retirement
Contents
Foreword xiii
Ronald F. Martin
Preface: Development of a Surgeon xv
Ronald F. Martin and Paul J. Schenarts
Medical School Training for the Surgeon 1
Christopher P. Scally and Rebecca M. Minter
This review outlines the current state of undergraduate medical education
for the surgeon in training and highlights ongoing efforts to improve the
preparation of graduating students entering surgical residency. Possible
models for improved integration of specialty specific training in medical
school are explored, and future directions in undergraduate surgical edu-
cation are considered in the context of ongoing curricular initiatives in
medical schools within North America.
Assessment of Competence: The Accreditation Council for Graduate Medical
Education/Residency Review Committee Perspective 15
John R. Potts III
Competency is an individual trait. As an agency that accredits programs
and institutions, the Accreditation Council for Graduate Medical Education
(ACGME) does not define or access competency. However, in the past 15
years the ACGME has promulgated several initiatives to aid programs in
the assessment of the competence of their residents and fellows. Those
initiatives include the Outcomes Project (which codified the compe-
tencies), the Milestones, and the Clinical Learning Environment Review
Program. In the near future, the ACGME will implement an initiative by
which programs can develop and study the results of competency-
based residency curricula.
Transition from Training to Surgical Practice 25
Thomas H. Cogbill and Stephen B. Shapiro
Surgical training graduates require a period of adjustment as they trans-
form from trainees to experienced surgeons. Making a smooth transition
is important for patient safety and new surgeon success. A subset of cur-
rent graduates does not feel confident to enter directly into practice. Res-
idency design with curriculum refocus, credentialing to encourage graded
responsibility, and increased operative exposure is necessary. Onboard-
ing programs should include formal mentoring, career counseling, proctor-
ing by senior surgeons, and objective review of outcomes. The ACS
developed a one-year TTP program to provide independent decision-
making, operative autonomy, mentoring by senior surgeons, and practice
management experience.
viii Contents
Alternative Considerations for Surgical Training and Funding 35
Ronald F. Martin
Since the late 1880s, surgical residency programs have existed in forms
that are similar to our current models. Many important variations have
been introduced over time. On aggregate this system has worked remark-
ably well; though as economic, demographic, and cultural changes
continue to evolve, one must wonder if we were to change our models,
how might we do that and what reasoning could we use. This article s
focus is to take a stratospheric view of what could be done, particularly
in the United States, rather than characterize what happens in other coun-
tries with other health economic systems.
Fellowship Training: Need and Contributions 47
Brandon T. Grover and Shanu N. Kothari
Surgical subspecialties are now well-established, and many surgery resi-
dents pursue fellowship training for various reasons. Fellowships can
bridge the gaps found in many residency programs by providing gradu-
ating residents with opportunities to master surgical skills, gain confidence
and progressive autonomy, and receive further mentorship. The experi-
ence also eases the transition to independent practice by allowing sur-
geons to tailor their training to coincide with personal interests and
future practice goals. It is unlikely that the number of surgery residents pur-
suing fellowship training will decrease, so it is important to provide the
infrastructure, oversight, and opportunities to meet their needs.
Surgical Residency Training at a University-Based Academic Medical Center 59
Rebecca L. Hoffman, Jon B. Morris, and Rachel R. Kelz
The past two decades have been witness to some of the most dynamic
changes that have occurred in surgical education in all of its history. Polit-
ical policies, social revolution, and the competing priorities of a new gen-
eration of surgical trainees are defining the needs of modern training
paradigms. Although the university-based academic program s tripartite
mission of clinical service, research, and education has remained stead-
fast, the mechanisms for achieving success in this mission necessitate
adaptation and innovation. The resource-rich learning environment and
the unique challenges that face university-based programs contribute to
its ability to generate the future leaders of the surgical workforce.
Evolving Educational Techniques in Surgical Training 71
Charity H. Evans and Kimberly D. Schenarts
Training competent and professional surgeons efficiently and effectively
requires innovation and modernization of educational methods. Today s
medical learner is quite adept at using multiple platforms to gain informa-
tion, providing surgical educators with numerous innovative avenues to
promote learning. With the growth of technology, and the restriction of
work hours in surgical education, there has been an increase in use of
simulation, including virtual reality, robotics, telemedicine, and gaming.
The use of simulation has shifted the learning of basic surgical skills to
Contents
ix
the laboratory, reserving limited time in the operating room for the acqui-
sition of complex surgical skills.
The Impaired Surgeon 89
Ranjan Sudan and Keri Seymour
Impaired physicians are unable to manage professional activities safely.
Impairment can be the result of physical or mental disorders, but impaired
physicians commonly refers to those suffering from substance use disor-
ders. These disorders are at least as common in physicians as they are in
the general population, and physician health programs have been estab-
lished in each state to provide expeditious and detailed evaluation, referral
to treatment facilities, and post-treatment monitoring to ensure compli-
ance. These programs protect participants against sanctions and safe-
guard patients. The prognosis for participants is excellent, with more
than 70% able to practice medicine at 5 years.
Workforce Needs and Demands in Surgery 95
Chandrakanth Are
The health care environment in the United States is witnessing major
changes. The Halstedian model has produced surgeons who joined the
workforce for over a century. While the Halstedian model will continue to
be of benefit, we need to be proactive and develop innovative models of
graduate medical education that meet the needs of the 21st century.
The history of graduate medical education is punctuated by surgical
leaders that made great contributions. The time is ripe again for the surgi-
cal community to develop innovative models of graduate medical educa-
tion that will continue to sustain the surgical workforce of the future.
Education and Training to Address Specific Needs During the Career Progression
of Surgeons 115
Ajit K. Sachdeva, Patrice Gabler Blair, and Linda K. Lupi
Surgeons have specific education and training needs as they enter prac-
tice, progress through the core period of active practice, and then as
they wind down their clinical work before retirement. These transitions
and the career progression process, combined with the dynamic health
care environment, present specific opportunities for innovative education
and training based on practice-based learning and improvement and
continuous professional development methods. Cutting-edge technolo-
gies, blended models, simulation, mentoring, preceptoring, and integrated
approaches can play critical roles in supporting surgeons as they provide
the best surgical care throughout various phases of their careers.
The Aging Surgeon: Implications for the Workforce, the Surgeon, and the Patient 129
Paul J. Schenarts and Samuel Cemaj
Surgeons suffer from the same physiologic impairments common to all
people with advancing age. These impairments not only affect the surgeon
but also the patients under their care. This article delineates the epidemi-
ologic context of the graying population of surgeons and the cognitive and
x Contents
physiologic changes that occur as the result of aging, the consequence of
which is that greater experience does not necessarily equate with better
clinical outcomes. This work also addresses potential methods for the
ongoing evaluation of the aging surgeon and how elder surgeons may
be best used as they reach the conclusion of their career.
Forks in the Road: The Assessment of Surgeons from the American Board of
Surgery Perspective 139
Jo Buyske
Surgical learning starts in medical school and continues through retire-
ment. Assessment of knowledge and skills across a variety of arenas at
each stage is an obligation of the profession in its duty to the public. The
American Board of Surgery is engaged in standardization and assessment
to a greater or lesser degree at each stage of surgical learning.
Residency Surgical Training at an Independent Academic Medical Center 147
Jeremiah Jones and Richard A. Sidwell
Independent academic medical centers have been training surgeons for
more than a century; this environment is distinct from university or military
programs. There are several advantages to training at a community pro-
gram, including a supportive learning environment with camaraderie be-
tween residents and faculty, early and broad operative experience, and
improved graduate confidence. Community programs also face chal-
lenges, such as resident recruitment and faculty engagement. With the
workforce needs for general surgeons, independent training programs
will continue to play an integral role.
Index
155
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| spelling | Development of a surgeon medical school through retirement editors Ronald F. Martin, Paul J. Schenarts Philadelphia, Pennsylvania Elsevier [2016] xvi, 162 Seiten Illustrationen txt rdacontent n rdamedia nc rdacarrier Surgical clinics of North America volume 96, number 1 (February 2016) Clinics review articles Martin, Ronald F. (DE-588)1081228199 edt Schenarts, Paul J. (DE-588)1071153951 edt Surgical clinics of North America volume 96, number 1 (February 2016) (DE-604)BV000003239 96,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=028703011&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Development of a surgeon medical school through retirement Surgical clinics of North America |
| title | Development of a surgeon medical school through retirement |
| title_auth | Development of a surgeon medical school through retirement |
| title_exact_search | Development of a surgeon medical school through retirement |
| title_full | Development of a surgeon medical school through retirement editors Ronald F. Martin, Paul J. Schenarts |
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| title_full_unstemmed | Development of a surgeon medical school through retirement editors Ronald F. Martin, Paul J. Schenarts |
| title_short | Development of a surgeon |
| title_sort | development of a surgeon medical school through retirement |
| title_sub | medical school through retirement |
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