Postgraduate training in general surgery

Weaknesses and perspectives from the residence

Abstract

In Uruguay, postgraduate education in general surgery has progressively decreased because of multiple factors. This paper analyzes the surgical volume and characteristics of surgical skills of six general surgeon residents during their postgraduate education in the Maciel Hospital (Hospital Maciel, Montevideo) from 1999 to 2001.
For the period of this short residency (3 years), fewer surgical procedures were recorded (mean: 259.6) compared to literature (360-600).
According to Categories of procedures, there is also a deficitarian aspect: 180 major surgery procedures, 20 high volume surgeries and only 1.3 complex surgeries.
There were 66.1% surgeries performed in the urgency ward, where no direct participation of educational teams is needed. This educational deficit and the absence of a professional certification system have transformed the academic teaching career in a second educational stage and a way of recognition by the market.
It is crucial to extend surgical residency for 4 years, to plan hospitalarian attendance in a full-time regime, to create public and private teaching units along the country, in a professional certification system.