Background: Transplant rotations as a core requirement for surgical training have been questioned. However, surgical resident perceptions of a fellow-led transplant service have not been well described.

Methods: Retrospective cross-sectional data were collected from categorical general surgery and integrated vascular and cardiothoracic surgery residents' service evaluations from 7/2014 through 7/2017. Surgical services were categorized as resident-led (Trauma/ACS, Endocrine, MIS, Oncology, Colorectal, HPB, and VA General & Vascular) and fellow-led (Transplant). A total of 31 variables were evaluated utilizing a 9-point, Likert-type scale and collapsed into 7 factors including clinical experience, educational experiences, clinical staff, workload, feedback, treatment of residents, and overall rotation. Postgraduate year (PGY) levels were grouped as PGY1-2, PGY3, and PGY4-5. Factor analysis and Cronbach's alpha were used to assess the uni-dimensionality and internal consistency of the factors. Mixed-effects modeling was used to ascertain differences in these factors, comparing the fellow-led transplant service and resident-led surgical services.

Results: Overall, 1330 resident evaluations were obtained. Among all PGY levels, the transplant service was rated significantly higher (P < 0.05) regarding clinical experience (7.32 vs 6.78), clinical staff (7.12 vs 6.66), workload (6.61 vs 6.30), treatment of residents (7.57 vs 7.06), and overall rotation (7.23 vs 6.73) when compared to resident-led services. However, no differences were noted in educational experiences and feedback. Regarding PGY level, PGY1-2 residents rated fellow-led services significantly higher in the areas of clinical experience, clinical staff, treatment of residents, and overall rotation with no differences in other categories when compared to resident-led surgical services. PGY 3 residents rated the transplant service significantly higher in all categories. However, PGY4-5 residents only rated the transplant service significantly higher in clinical experience and feedback. No categories were rated significantly higher for resident-led services.

Conclusions: Surgical residents value the educational experiences of the fellow-led transplant service. Senior residents see it as at least similar to other surgical core rotations, while junior and mid-level residents report significant advantages to training.

CITATION INFORMATION: Williams A., Barrett M., Matusko N., Dennahy S., Sung R., Sandhu G., Woodside K. Resident Perceptions and Evaluations of a Fellow-Led Transplant Service versus Resident-Led Surgical Services Am J Transplant. 2017;17 (suppl 3).

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