Affiliation:
1. Division of Transplant Surgery University of California San Francisco San Francisco California USA
2. Department of Surgery University of Texas Southwestern Medical Center Dallas Texas USA
3. Department of Surgery University of Wisconsin Madison Wisconsin USA
4. Department of Surgery Cincinnati Research on Education in Surgical Training (CREST) University of Cincinnati Cincinnati Ohio USA
Abstract
ABSTRACTBackgroundTransplant surgery has historically been a less desirable fellowship among general surgery graduates. Limited work has been done to understand factors associated with residents’ interest in transplantation. Using a multi‐institutional cohort, we examined how the resident experience on transplant surgery may influence their decision to pursue transplant fellowship.MethodsIndividual demographics, program characteristics, and transplant‐specific case logs were collected for graduates from 2010 to 2020 at 20 general surgery residency programs within the US Resident OPerative Experience (ROPE) Consortium. Residents who pursued transplant surgery fellowship were compared to those who went directly into practice or pursued a non‐transplant fellowship.ResultsAmong 1342 general surgery graduates, 52 (3.9%) pursued abdominal transplant fellowship. These residents completed more transplant (22 vs. 9), liver (14 vs. 9), pancreas (15 vs. 11), and vascular access operations (38 vs. 30) compared to residents who did not pursue transplant fellowship (all p < 0.05). Multivariable logistic regression found that residents underrepresented in medicine were three times more likely (95% CI 1.54–6.58, p < 0.01) and residents at a program co‐located with a transplant fellowship six times more likely (95% CI 1.95–18.18, p < 0.01) to pursue transplant fellowship. Additionally, a resident's increasing total transplant operative volume was associated with an increased likelihood of pursuing a transplant fellowship (OR = 1.12, 95% CI 1.09–1.14, p < 0.01).ConclusionThe findings from this multi‐institutional study demonstrate that increased exposure to transplant operations and interaction within a transplant training program is associated with a resident's pursuit of transplant surgery fellowship. Efforts to increase operative exposure, case participation, and mentorship may optimize the resident experience and promote the transplant surgery pipeline.