Does surgery residency prepare residents to work at critical access hospitals?

Vicente Undurraga Perl, Brian Diggs, Bruce Ham, Martin Schreiber

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background Operations performed by surgeons working at Critical Access Hospitals (CAHs) and surgery residents have not been compared. Methods Procedure codes logged by general surgery residents graduating from our institution in 2013 and 2014 were obtained. Procedure codes were obtained for all CAHs in our state for 2012 to 2013. Clinically relevant categories were compared among residents and general surgeons at CAHs. Results A total of 34,246 procedures logged by general surgeons at CAHs were compared with 31,977 procedures logged by surgery residents. Endoscopy comprised 56.1% of cases done by general surgeons versus 9.1% of cases by residents (P <.001). Excluding endoscopy, rural surgeons had higher percentages in hernia, skin/soft tissue, cholecystectomy/common bile duct, rectal/anal, and breast cases. Residents who completed a rural surgery rotation had higher numbers in small/large bowel, hernia, breast, and endoscopy. Conclusions Surgery residency provides less exposure to endoscopy compared with a general surgery practice at CAHs. A rural rotation increases endoscopic exposure.

Original languageEnglish (US)
Pages (from-to)828-833
Number of pages6
JournalAmerican journal of surgery
Issue number5
StatePublished - May 1 2015


  • Critical access hospitals
  • General surgery training
  • Procedures
  • Rural surgery


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