The financial impact of teaching surgical residents in the operating room

BACKGROUND: There have been no published data regarding the cost of trainin g surgical residents in the operating room. METHODS: At the University of Tennessee Medical Center-Knoxville, in additi on to resident-performed teaching cases, some cases are performed without t he assistance of residents by the same faculty. RESULTS: Sixty-two case categories involving 14,452 cases were compared for operative times alone. In 46 case categories (10,787 procedures), resident operative times were longer than faculty alone. In 16 case categories, res ident operating times were shorter than faculty times. The net incremental operative time cost was 2,050 hours between July 1993 and March 1997, Assum ing 4 years of operative training for 11 graduating chief residents, the co st per graduating resident was $47,970, CONCLUSION: Extrapolated to a national annual cost for the 1,014 general su rgery residents who completed training in the 1997 academic year, the annua l cost of training residents in the operating room is $53 million. This hig h monetary cost suggests the need for digital skills, selection criteria, t he development of training curriculum and resource facilities, the pre-oper ating room need for suturing and stapling techniques, and perhaps the acqui sition of virtual surgery training modules. Am J Surg. 1999;177:28-32. (C) 1999 by Excerpta Medica, Inc.