eP429 - Examining the Influence of the General Surgery Resident Colorectal Experience on the Pursuit of Colorectal Surgery Fellowship

Author(s)

• AP

  Adam D. Price, MD

  Resident Physician
  University of Cincinnati
  Cincinnati, Ohio, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

ePoster Presenter(s)

• 

  Bilal W. Nasim, MD

  General Surgery Resident
  UT Health San Antonio
  UT Health San Antonio
  San Antonio, TX, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• 

  Frances Hu, MD, MSc (she/her/hers)

  General Surgery Resident
  Brigham & Women's Hospital
  Brigham and Women’s Hospital
  Boston, MA, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• DL

  Desmond Layne, M.D., M.S.

  General Surgery Resident
  University of Wisconsin Hospitals and Clinics
  Verona, Wisconsin, United States

  Disclosure information not submitted.
• RR

  Robyn Richmond, MD

  Associate Professor of Surgery
  Texas Tech University Health Sciences Center
  Lubbock, Texas, United States

  Disclosure information not submitted.
• ZH

  Zachary E. Hier, MD

  General Surgery Resident
  University of Louisville Department of Surgery
  Louisville, Kentucky, United States

  Disclosure information not submitted.
• AM

  Antonela Muca, MD

  Resident
  Corewell Health East
  Ann Arbor, Michigan, United States

  Disclosure information not submitted.
• AC

  Alexander R. Cortez, MD

  Fellow
  UCSF
  San Francisco, California, United States

  Disclosure information not submitted.
• 

  Jonathan Abelson, MD MS (he/him/his)

  Staff Surgeon
  Lahey Hospital and Medical Center
  Tufts Medical Center
  ARLINGTON, Massachusetts, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.

Senior Author(s)

• 

  Jitesh A. Patel, MD, MBA

  Professor of Surgery
  University of Kentucky
  University of Kentucky
  Lexington, KY, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.

Purpose/Background: Colon and Rectal Surgery (CRS) is a highly sought after and competitive fellowship following General Surgery (GS) residency. However, it has not been studied as to how a resident’s CRS experience during residency impacts their career choice and pursuit of CRS. This study aims to identify individual and program factors associated with matriculation into CRS fellowship.Methods/Interventions: An analysis of case logs and demographic data from graduates of 19 ACGME-accredited GS residency programs between 2010-2020 was completed utilizing the US Resident OPerative Experience (ROPE) Consortium. The demographics and operative experience of residents who pursued CRS fellowship were compared to those who did not. Among all programs, the rate of pursuing CRS was 7.6%. Residency programs above the median (‘feeder programs’, n=10) were compared to programs below the median (n=9).Results/Outcomes: 1,287 residents completed residency during the study period and 104 (8.1%) matched into CRS fellowship. Those who pursued CRS fellowship were more likely to be female (47% vs 35%, p=0.01) and have completed a dedicated research experience (54% vs 43%, p=0.03) compared to those not pursuing CRS. The total operative experience upon graduation was similar between the two groups (1156 vs 1166 cases, p=0.68). However, graduates who pursued CRS fellowship logged more CRS-specific cases (136 vs 122, p < 0.01), which comprised of more small intestine cases (44 vs 39, p < 0.01), large intestine cases (167 vs 144, p < 0.01), anorectal cases (45 vs 30, p < 0.01), and colonoscopies (62 vs 55, p < 0.01) (Figure). Multivariable logistic regression demonstrated a higher likelihood of CRS fellowship pursuit for female residents (OR 1.67, p=0.02) and residents who completed a clinical 4th year (R4) CRS rotation (OR 2.55, p < 0.01). Furthermore, there was direct association between CRS-specific cases (OR 1.03, p < 0.01) and going into CRS. Comparing residency programs, ‘feeder programs’ employed more CRS faculty (7 vs 4, p < 0.01) and their residents completed more months on a CRS service during residency (6 vs 5, p < 0.01), including a dedicated R4 CRS rotation (67% vs 26%, p < 0.01).Conclusion/

Discussion: This multi-institutional study identified individual and program-specific factors associated with matching into CRS fellowship following GS residency. Certain residency programs may act as “CRS feeder programs” by increasing resident time spent on a CRS service, supporting a dedicated R4 CRS rotation, and employing more CRS faculty. These data can be leveraged to optimize the resident CRS experience and strengthen the CRS fellowship pipeline.Case volume of residents pursuing CRS vs. residents not pursuing CRSCase numbers of residents who pursued fellowship in CRS compared to those who did not in domains related to CRS (small intestine, p < 0.01; large intestine, p < 0.01; and anorectal, p < 0.01), as well as CRS-specific cases (p < 0.01).