Impact of a colon and rectal surgeon on a general surgery residency training program

PURPOSE: Most general surgery residents obtain scant exposure to anorectal disease during training. The aim of this study was to determine whether add ing a colon and rectal surgeon to the faculty of a general surgery training program improves the amount or quality of the anorectal surgical experienc e. METHODS: The surgical experience of all graduating residents from our un iversity teaching program was reviewed during a ten-year period. Complete c ase data were obtained from the Residency Review Committee for surgery. The total small-intestine, colon and anorectal caseload was analyzed during th e five-year period preceding the arrival of the colon and rectal surgeon an d compared with the subsequent five-year period after the surgeon's arrival . RESULTS: There was a substantial increase in small-intestine (470 vs. 306 ) and anorectal cases (462 vs. 338). There was a particularly dramatic incr ease in anorectal cases per formed during the chief resident year (159 vs. 36), which held true for all categories of anorectal cases. CONCLUSIONS: Th e addition of a full-time colon and rectal surgeon to a university general surgery residency program was associated with an increase in small-intestin e and especially anorectal cases. However, most striking was the greater th an fourfold increase in the number of anorectal cases performed during the chief resident year. This seems to reflect an increase in complexity of ano rectal cases and an increased interest in anorectal surgery among general s urgery residents.