{"id":3606,"date":"2017-01-24T00:00:00","date_gmt":"2017-01-24T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/new-surgeon-outcomes-and-the-effectiveness-of-surgical-training-a-population-based-cohort-study\/"},"modified":"2023-06-14T19:54:46","modified_gmt":"2023-06-14T23:54:46","slug":"new-surgeon-outcomes-and-the-effectiveness-of-surgical-training-a-population-based-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/new-surgeon-outcomes-and-the-effectiveness-of-surgical-training-a-population-based-cohort-study\/","title":{"rendered":"New surgeon outcomes and the effectiveness of surgical training: a population-based cohort study"},"content":{"rendered":"<p><strong>Purpose<\/strong> &#x2014; Reports have questioned the technical proficiency of newly graduating surgeons. However, objective data supporting these concerns are limited. Surgical outcomes among recent graduates are an important indicator of residency programs&apos; ability to graduate surgeons who are ready to meet the needs of their patients. This study aimed to investigate the association between a surgeon&apos;s number of years of independent practice and the risk of surgical adverse events.<\/p>\n<p><strong>Design <\/strong>&#x2014; Population-based cohort study.<\/p>\n<p><strong>Participants<\/strong> &#x2014; All patients 66 years of age or older undergoing isolated cataract operations in Ontario, Canada, between January 1, 1997, and December 31, 2013.<\/p>\n<p><strong>Methods<\/strong> &#x2014; Cataract surgical outcomes for all operations performed by surgeons commencing practice in the study period were evaluated using linked healthcare databases.<\/p>\n<p><strong>Main Outcome Measures<\/strong> &#x2014; Four serious complications were evaluated: posterior capsule rupture, dropped lens fragments, retinal detachment, and suspected endophthalmitis. Analyses controlled for patient-, surgeon-, and institution-level covariates.<\/p>\n<p><strong>Results<\/strong> &#x2014; The study evaluated 1&#x2009;431&#x2009;320 cataract operations. Surgeons in their first year of independent practice were more than 9 times more likely to have high complication rates (&#x2265;2%) than surgeons in their tenth year (odds ratio [OR], 9.3; 95% confidence interval [CI], 2.7&#x2013;31.9). Each additional year of independent practice was associated with a 10% decrease in the risk of patients experiencing an adverse surgical event (OR, 0.90 per year of surgeon independent practice; 95% CI, 0.87&#x2013;0.94).<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; In this population-based study, surgical complications were significantly more likely early in surgeons&apos; careers. Interventions may be needed in postgraduate surgical training and early independent career monitoring and mentoring processes to ensure patient safety while continually renewing the surgical workforce.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Purpose &#x2014; Reports have questioned the technical proficiency of newly graduating surgeons. However, objective data supporting these concerns are limited. Surgical outcomes among recent graduates are an important indicator of residency programs&apos; ability to graduate surgeons who are ready to meet the needs of their patients. This study aimed to investigate the association between a [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[62,25],"migration-helper-qa-sample-set":[],"class_list":["post-3606","journal_article","type-journal_article","status-publish","hentry","topic-health-services-research","topic-surgery"],"acf":{"citation":"Campbell RJ, El-Defrawy SR, Gill SS, Whitehead M, Campbell ELP, Hooper PL, Bell CM, ten Hove M. <em>Ophthalmology<\/em>. 2017; 124(4):532-8. Epub 2017 Jan 24.","source_url":"","ices_scientist":[1203,1251,1172,17132],"site":[6736],"research_program":[6746],"news_release":[7595],"journal_article":[],"atlas":[],"research_report":[],"infographic":[9427],"video":[],"downloads":null,"links":null,"sitecore_item_id":"5972D318-A1BA-4A70-8572-A6DEF5DB0737","sitecore_item_name":"New-surgeon-outcomes-and-the-effectiveness-of-surgical-training","sitecore_field_values":"{\n  \"__Valid from\": \"20170320T120300\",\n  \"Title\": \"New surgeon outcomes and the effectiveness of surgical training: a population-based cohort study\",\n  \"Short title\": \"New surgeon outcomes\",\n  \"Summary\": \"This study examined the association between a surgeon's number of years of independent practice and the risk of surgical adverse events.\",\n  \"Citation\": \"<p>Campbell RJ, El-Defrawy SR, Gill SS, Whitehead M, Campbell ELP, Hooper PL, Bell CM, ten Hove M. <em>Ophthalmology<\/em>. 2017; 124(4):532-8. Epub 2017 Jan 24.<\/p>\",\n  \"Abstract\": \"<p><strong>Purpose<\/strong> &mdash; Reports have questioned the technical proficiency of newly graduating surgeons. However, objective data supporting these concerns are limited. Surgical outcomes among recent graduates are an important indicator of residency programs' ability to graduate surgeons who are ready to meet the needs of their patients. This study aimed to investigate the association between a surgeon's number of years of independent practice and the risk of surgical adverse events.<\/p>rn<p><strong>Design <\/strong>&mdash; Population-based cohort study.<\/p>rn<p><strong>Participants<\/strong> &mdash; All patients 66 years of age or older undergoing isolated cataract operations in Ontario, Canada, between January 1, 1997, and December 31, 2013.<\/p>rn<p><strong>Methods<\/strong> &mdash; Cataract surgical outcomes for all operations performed by surgeons commencing practice in the study period were evaluated using linked healthcare databases.<\/p>rn<p><strong>Main Outcome Measures<\/strong> &mdash; Four serious complications were evaluated: posterior capsule rupture, dropped lens fragments, retinal detachment, and suspected endophthalmitis. Analyses controlled for patient-, surgeon-, and institution-level covariates.<\/p>rn<p><strong>Results<\/strong> &mdash; The study evaluated 1&thinsp;431&thinsp;320 cataract operations. Surgeons in their first year of independent practice were more than 9 times more likely to have high complication rates (&ge;2%) than surgeons in their tenth year (odds ratio [OR], 9.3; 95% confidence interval [CI], 2.7&ndash;31.9). Each additional year of independent practice was associated with a 10% decrease in the risk of patients experiencing an adverse surgical event (OR, 0.90 per year of surgeon independent practice; 95% CI, 0.87&ndash;0.94).<\/p>rn<p><strong>Conclusions<\/strong> &mdash; In this population-based study, surgical complications were significantly more likely early in surgeons' careers. Interventions may be needed in postgraduate surgical training and early independent career monitoring and mentoring processes to ensure patient safety while continually renewing the surgical workforce.<\/p>\",\n  \"Keywords\": \"{9F514AF9-2526-48FE-8414-54C443CF99AD}|{A39C5396-16B7-4369-B0F9-31F6E91E46FC}|{E6C83141-5D86-409C-B4E1-8DD620508038}\",\n  \"Related Products\": null,\n  \"Research Programs\": \"{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n  \"ICES Locations\": \"{5A12C65D-3CDA-413E-BC94-C1D778156CE6}\",\n  \"ICES Scientists\": \"{F8C8C01B-CFDC-4601-804E-F7C502970FCC}|{5B2D929C-DA9B-45B8-8DAA-8150B2E76063}|{9F60496B-63FD-4BE5-A7EF-C4969D7AACB3}\",\n  \"Posted Date\": \"20170124T000000\",\n  \"Show on Publications Landing Page\": \"1\",\n  \"In The News\": \"{765253A4-782E-4738-B854-3CD0CDB2BA43}\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2017\/January\/New-surgeon-outcomes-and-the-effectiveness-of-surgical-training"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | New surgeon outcomes and the effectiveness of surgical training: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Purpose &#x2014; Reports have questioned the technical proficiency of newly graduating surgeons. 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