The Surgical clinics of North America
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Liver anatomy can be variable, and understanding of anatomic variations is crucial to performing hepatic resections, particularly parenchymal-sparing resections. Anatomic knowledge is a critical prerequisite for effective hepatic resection with minimal blood loss, parenchymal preservation, and optimal oncologic outcome. Each anatomic resection has pitfalls, about which the operating surgeon should be aware and comfortable managing intraoperatively.
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Surgical subspecialties are now well established, and many surgery residents pursue fellowship training for various reasons. Fellowships can bridge the gaps found in many residency programs by providing graduating residents with opportunities to master surgical skills, gain confidence and progressive autonomy, and receive further mentorship. The experience also eases the transition to independent practice by allowing surgeons to tailor their training to coincide with personal interests and future practice goals. It is unlikely that the number of surgery residents pursuing fellowship training will decrease, so it is important to provide the infrastructure, oversight, and opportunities to meet their needs.
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Surg. Clin. North Am. · Feb 2016
ReviewAssessment of Competence: The Accreditation Council for Graduate Medical Education/Residency Review Committee Perspective.
Competency is an individual trait. As an agency that accredits programs and institutions, the Accreditation Council for Graduate Medical Education (ACGME) does not define or access competency. ⋯ Those initiatives include the Outcomes Project (which codified the competencies), the Milestones, and the Clinical Learning Environment Review Program. In the near future, the ACGME will implement an initiative by which programs can develop and study the results of competency-based residency curricula.
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Surg. Clin. North Am. · Feb 2016
ReviewSurgical Residency Training at a University-Based Academic Medical Center.
The past two decades have been witness to some of the most dynamic changes that have occurred in surgical education in all of its history. Political policies, social revolution, and the competing priorities of a new generation of surgical trainees are defining the needs of modern training paradigms. Although the university-based academic program's tripartite mission of clinical service, research, and education has remained steadfast, the mechanisms for achieving success in this mission necessitate adaptation and innovation. The resource-rich learning environment and the unique challenges that face university-based programs contribute to its ability to generate the future leaders of the surgical workforce.
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Surg. Clin. North Am. · Feb 2016
ReviewResidency Surgical Training at an Independent Academic Medical Center.
Independent academic medical centers have been training surgeons for more than a century; this environment is distinct from university or military programs. There are several advantages to training at a community program, including a supportive learning environment with camaraderie between residents and faculty, early and broad operative experience, and improved graduate confidence. Community programs also face challenges, such as resident recruitment and faculty engagement. With the workforce needs for general surgeons, independent training programs will continue to play an integral role.