PS4-04: POST-GRADUATE ASSESSMENT OF GENERAL SURGERY ACGME MILESTONES: A MULTI-INSTITUTIONAL PILOT QUALITY IMPROVEMENT PROJECT
Jason W Kempenich, MD1, Ross E Willis, PhD1, Uzer S Khan, MD2, Megan E Miller, MD3, Daniel L Dent, MD1, Mohsen M Shabahang, MD, PhD4; 1UT Health San Antonio, 2Health Sciences Center West Virginia University, 3Case Western Reserve University School of Medicine, 4Geisinger Surgery Institute
Purpose: Post-graduate evaluation of general surgery residents and feedback to program directors consists almost entirely of American Board of Surgery pass rates. Additional feedback tends to be rare and anecdotal. The purpose of our study was to create a post-graduate assessment tool based on ACGME Milestones to allow general surgery residency program directors to evaluate their graduates after training.
Methods: An expert group of surgical educators created a graduate assessment tool based on specific anchor statements derived from the ACGME General Surgery Milestones Project. The tool was evaluated for appropriate correlation to the Milestone anchor statement level. The finalized assessment tool was distributed to employers of all residents from three general surgery residency programs at least 12-24 months after the resident graduated. Each resident’s final pre-graduation Milestones evaluation was then compared to the post-graduate assessment responses.
Results: Twenty-nine general surgery graduates were included with an employer evaluation response rate of 59%. Graduate practice type after residency included: fellowship 53%, private/community practice 21%, specialized residency training 16%, and academic 11%. All employers reported “always” or “most of the time” to the eight anchor statements evaluated (Table). This correlated with high Milestones scores from the program directors. Twenty-six percent of employers reported having received negative feedback regarding graduates' personal interactions.
Table: Milestone anchors used to create the assessment.
Conclusion: Despite recent reports that general surgery graduates are unprepared for fellowship or practice, all employers queried agreed with program directors that residents showed appropriate competency with regard to the Milestones evaluated in this study. Early attention to interpersonal communication may improve graduates’ reception in their new practice environment.