PRIORITIES IN GENERAL SURGICAL TRAINING

PURPOSE: We wished to determine which area of surgical resident traini ng receives the highest priority-surgical technique, surgical judgment , or ''book knowledge.'' We were also interested in how the programs a ddressed each area, particularly the teaching of surgical technique. M ETHODS: A questionnaire was distributed to the program directors and c hief residents of all 289 general surgery residency programs in the Un ited States. RESULTS: Answers were received from 144 chief residents ( 50%) and 152 program directors (53%). Programs to teach surgical judgm ent and technique were offered by 55 (36%) and 68 (45%) of general sur gical residencies. Most program directors (83%) and chief residents (7 2%) considered surgical judgment the most important aspect of surgical training. Sixty-four percent of chief residents felt they were receiv ing adequate training in the technical aspects of surgery. Approximate ly half of the program directors felt that residents needed better tra ining in the technical aspects of surgery. One hundred thirty programs (86%) had specific curricula for teaching ''book knowledge.'' CONCLUS IONS: With the advent of minimal access surgery and the constant intro duction of new instruments and procedures, new demands are constantly being placed on practicing surgeons. in order to prevent the further f ragmentation of general surgery, a more structured approach to the ear ly teaching of surgical skills should be considered.