A reader asks if I have “any advice on choosing a surgery residency, e.g. academic, community, hybrid?” I’m not sure what a “hybrid” residency is, but I think he meant a university program with extensive exposure to community hospital rotations. Having been a community hospital residency program director for many years I was always partial to that type of program. I felt that we trained people who got more operative experience and were more confident in their skills. A paper in the Journal of the American College of Surgeons co-authored by [believe it or not] surgeons from Yale, Memorial Sloan Kettering Cancer Center and the American Board of Surgery validated my impression. The paper was a survey of 4282 residents, who comprised 80% of all categorical surgical residents in 2007-2008. Table 2 of that paper shows that residents at community hospitals are statistically significantly more satisfied with their operative experience and less likely to worry that they will not be confident operating by themselves after they finish training than university trainees. [I have blogged before about resident lack of confidence.] Surprisingly, they were also happier with the level of didactic teaching than university-based residents. Of course, the choice of where to train depends on what the prospective trainee wants to do with her career in the long term. If one wants to be an “academic surgeon,” one might overlook the above deficiencies of university residencies. However, I always told my residents that they could get their academic ticket punched by taking a fellowship in a university program. Remember, the definition of the word “academic” is varied. One online dictionary contains the following [emphasis added]: of or pertaining to a college, academy, school, or other educational institution, especially one for higher education: academic requirements. pertaining to areas of study that are not primarily vocational or applied, as the humanities or pure mathematics. theoretical or hypothetical; not practical, realistic, or directly useful: an academic question; an academic discussion of a matter already decided. learned or scholarly but lacking in worldliness, common sense, or practicality. So, choose wisely, my friends. Source
