Article
Tutorial assistance for board certification in surgery: Frequency, associated time and costs
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Authors
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Robert Mechera
- Basel, Switzerland
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Salome Dell-Kuster
- Universitätsspital Basel, Chirurgie, Basel, Switzerland
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Marco von Strauss und Torney
- Kantonsspital Aarau, Chirurgie, Aarau, Switzerland
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Langer Igor
- Lindenhofspital, Chirurgie, Bern, Switzerland
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Markus Furrer
- Kantonsspital Graubünden, Chirurgie, Chur, Switzerland
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Heiner Bucher
- Universitätsspital Basel, Institute for Clinical Epidemiology and Biostatistics, Basel, Switzerland
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Rachel Rosenthal
- Universitätsspital Basel, Institute for Clinical Epidemiology and Biostatistics, Basel, Switzerland
| Published: | April 21, 2016 |
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Outline
Text
Background: Tutorial assistance is related to extra time and cost and the hospitals’ financial compensation for this activity is under debate. We aimed at quantifying the time and resulting cost required to train one surgical resident in the operating theatre for board certification in Switzerland.
Materials and methods: We analysed data of 212’948 surgeries carried out between 2008 and 2012. The percentage of procedures carried out by residents as compared to three higher levels of surgical seniority was assessed. Average duration of procedure categories by different seniority levels was calculated and extra time and resulting cost were analysed.
Results: On average, residents performed about a third of all surgeries even in typical teaching procedures like appendectomies. An increase in duration and cost of well-defined procedure categories was demonstrated, if a resident performed the procedure. In less well-defined ones, residents seemed to perform less difficult procedures than senior consultants resulting in shorter durations of surgery. Total cost for duration of surgeries necessary for board certification of one resident reaches a maximum of 2 million Euros.
Conclusion: The financial impact of tutorial assistance is important and solutions need to be found to compensate for this activity, especially in times when reimbursement of training in general remains an unsolved issue and a relevant cost driver for teaching hospitals. The low percentage of procedures performed by trainees may make it difficult to fulfil requirements for board certification within a reasonable period of time.
