• Brandon M Wojcik, Fong Zhi Ven ZV Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts., Madhukar S Patel, David C Chang, Emil Petrusa, John T Mullen, and Roy Phitayakorn.
• Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
• J Surg Educ. 2016 Nov 1; 73 (6): e142-e149.

ObjectiveGeneral surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program.DesignSingle institution case-control pilot study of a resident-run minor surgery clinic from 9/2014 to 6/2015. Rotating third-year residents staffed the clinic once weekly. Residents performed operations independently in their own procedure room. A supervising attending surgeon staffed each case prior to residents performing the procedure and viewed the surgical site before wound closure. Postprocedure patient complications and admissions to the hospital because of a complication were analyzed and compared with an attending control cohort.SettingMassachusetts General Hospital General in Boston, MA; an academic tertiary care general surgery residency program.ParticipantsTen third-year general surgery residents.ResultsOverall, 341 patients underwent a total of 399 procedures (110 in the resident clinic vs. 289 in the attending clinic). Minor surgeries included soft tissue mass excision (n = 275), abscess incision and drainage (n = 66), skin lesion excision (n = 37), skin tag removal (n = 15), and lymph node excision (n = 6). There was no significant difference in the overall rate of patients developing a postprocedure complication within 30 days (3.6% resident vs. 2.8% attending; p = 0.65); which persisted on multivariate analysis. Similar findings were observed for the rate of hospital admission resulting from a complication. Resident evaluations overwhelmingly supported the rotation, citing increased operative autonomy as the greatest strength.ConclusionsImplementation of a resident-run minor surgery clinic is a safe and effective method to increase trainee operative autonomy. The rotation is well suited for mid-level residents, as it provides an opportunity for realistic self-evaluation and focused learning that may enhance their operative experience during senior level rotations.Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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