Pediatric Surgery (Integrated)

[moneduloides]

Out of curiosity, have those in the know heard any talk of a possible integrated path to pediatric surgery in the future? I'd also love to hear any opinions on the matter; as there are parties for/against the somewhat recent trend toward this path in CT I'm sure peds surg would be no different, and perhaps even more averse to the transition for a number of reasons.

---

Members don't see this ad.

 

[SocialistMD]

I'm not sure I'm "in the know," but I do know it was a topic of discussion at last year's APSA program directors' meeting. Basically, they have been against it for a long time, as they want fully trained general surgeons. However, due to changes in the ABS requirements for graduating general surgery residents, they realize fully trained general surgeons aren't graduating anymore (exposure to thoracic, knowledge of advanced HPB, etc...), so they are now considering moving towards the early specialization model in an effort to increase the exposure of future pediatric surgeons to those "general surgery" operations they aren't seeing anymore.

 

[moneduloides]

I'm not sure I'm "in the know," but I do know it was a topic of discussion at last year's APSA program directors' meeting. Basically, they have been against it for a long time, as they want fully trained general surgeons. However, due to changes in the ABS requirements for graduating general surgery residents, they realize fully trained general surgeons aren't graduating anymore (exposure to thoracic, knowledge of advanced HPB, etc...), so they are now considering moving towards the early specialization model in an effort to increase the exposure of future pediatric surgeons to those "general surgery" operations they aren't seeing anymore.

Understanding this is all conjecture, is it your feeling a pediatric surgery residency would manifest itself as more pediatrics than not, or do you think the APSA wants residents to still be trained with adults for the most part? I'm curious, because something like a pediatric only (or mostly, even) residency at, say, a children's hospital, would be a pretty unique surgical path - as I understand it, other integrated paths consist of a majority, or significant, amount of time in general prior to dedicated specialty training. If you hopped into a ped surg residency at a children's hospital you'd never have to do anything but ped surg the entire residency. Alternatively, such an institution could have you spend the first year/two at the associated adult hospital doing gen surg.

 

[vamz]

I'm not one "in the know" either, but I'd like to share a few thoughts.

I for one had a very limited exposure to pediatric surgery as a medical student. Even though we had a service, we were not a large regional pediatric hospital, therefore the range of pathology & types of cases were rather narrow. It's probably difficult for med students to be in a position to make a truly informed choice, especially given the economic & practice constraints of pediatric surgery (private practice peds surgery anyway).

Second, I think it's potentially a logistical nightmare for programs to open up to all the potential applicants straight out of medical school. For example, last year, there were only 44 peds surgery spots & twice as many applicants. At the same time, there were 1100 or so general surgery spots & nearly twice that many applicants. Of course I'm not saying all of them would apply, but without the self selection of recommendations & ABSITE scores, it would be a larger percentage than of general surgery residents. Not to mention, there might be some med students who would go the peds surgery route instead of peds - granted a small number.

I do not think that it will ever be a start as a PGY-1 peds surgery resident, simply because you need to develop the necessary dexterity to work on newborns' delicate tissues - skills you acquire operating on adults.

It might be that peds surgery ends up with an early specialization option, but I have a feeling that for the near future at least, it's going to stay in the traditional format.

 

[DoctwoB]

I do not think that it will ever be a start as a PGY-1 peds surgery resident, simply because you need to develop the necessary dexterity to work on newborns' delicate tissues - skills you acquire operating on adults.
.

Do you think a 3+3 track would solve that problem?