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. 2017 Nov;27(11):2974-2980.
doi: 10.1007/s11695-017-2729-z.

Resident Training in Bariatric Surgery-A National Survey in the Netherlands

Gabrielle H van Ramshorst  1   2 , Mirjam A Kaijser  3   4 , Jean-Pierre E N Pierie  3   4 , Bart A van Wagensveld  5
Affiliations

Resident Training in Bariatric Surgery-A National Survey in the Netherlands

Gabrielle H van Ramshorst et al. Obes Surg. 2017 Nov.

Abstract

Purpose: Surgical procedures for morbid obesity, including laparoscopic Roux-en-Y gastric bypass (LRYGB), are considered standardized laparoscopic procedures. Our goal was to determine how bariatric surgery is trained in the Netherlands.

Materials and methods: Questionnaires were sent to lead surgeons from all 19 bariatric centers in the Netherlands. At least two residents or fellows were surveyed for each center. Dutch residents are required to collect at least 20 electronic Objective Standard Assessment of Technical Skills (OSATS) observations per year, which include the level of supervision needed for specific procedures. Centers without resident accreditation were excluded.

Results: All 19 surgeons responded (100%). Answers from respondents who worked at teaching hospitals with residency accreditation (12/19, 63%) were analyzed. The average number of trained residents or fellows was 14 (range 3-33). Preferred procedures were LRYGB (n = 10), laparoscopic gastric sleeve (LGS) resection (n = 1), or no preference (n = 1). Three groups could be discerned for the order in which procedural steps were trained: unstructured, in order of increasing difficulty, or in order of chronology. Questionnaire response was 79% (19/24) for residents and 73% (8/11) for fellows. On average, residents started training in bariatric surgery in postgraduate year (PGY) 4 (range 0-5). The median number of bariatric procedures performed was 40 for residents (range 0-148) and 220 during fellowships (range 5-306).

Conclusions: Training in bariatric surgery differs considerably among centers. A structured program incorporating background knowledge, step-wise technical skills training, and life-long learning should enhance efficient training in bariatric teaching centers without affecting quality or patient safety.

Keywords: Bariatric surgery; Coaching; Gastric bypass; Gastric sleeve; Learning; Teaching.

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Conflict of interest statement

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.

Supportive Foundations

There was no funding in the development of this article. No grants or fellowships were used to support the paper.

Grant Support

None.

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