Back to 2025 Abstracts
Predicting General Surgery Residents’ Competence And Autonomy In Core Endovascular Surgery Procedures
Pavan Guduri, MD, Rebecca Moreci, MD, Ting Sun, PhD, Misaki Kiguchi, MD, Brian George, MD, Malachi Sheahan III, MD, Brigitte Smith, MD.
Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Objective:Vascular surgery continues to be a core component of general surgery training according to the Accreditation Council for Graduate Medical Education (ACGME) and American Board of Surgery (ABS). As the indications for and use of endovascular approaches to vascular surgery expand, the extent of endovascular exposure general surgery residents receive is unknown. With a projected shortage of vascular surgeons and a projected increase in the proportion of endovascular procedures performed, endovascular skills may be necessary for a subset of graduating general surgery residents (GSRs), particularly those entering community practice. This study investigates the competence and autonomy levels of GSRs in core endovascular surgery procedures.
Methods:Endovascular operative evaluations were collected from categorical general surgery residents between 2015-2024 using the Society for Improving Medical Professional Learning (SIMPL) database. The endovascular procedures were categorized into five major areas: arteriovenous (AV) access, endovenous, cerebrovascular, endoaortic, and peripheral vascular intervention (PVI). Ratings were analyzed using generalized linear mixed models (GLMM). The primary outcome was graduating residents’ predicted probability of being competent or meaningfully autonomous to perform endovascular procedures.
Results:1312 SIMPL operative assessments were analyzed across 65 general surgery residency programs. For a case of average complexity, graduating GSRs had an adjusted probability of being competent to perform both AV access and endovenous procedures of 92% (Interquartile range [IQR] 83-94% and 84-94%, respectively), a cerebrovascular procedure of 62% (IQR 36-70%), an endoaortic procedure of 66% (IQR 46-68%), and a PVI procedure of 76% (IQR 56-79%). For a case of average complexity, graduating GSRs had an adjusted probability of being meaningfully autonomous to perform an AV access procedure of 87% (IQR 83-91%), an endovenous procedure of 90% (IQR 87-93%), a cerebrovascular procedure of 29% (IQR 20-36%), an endoaortic procedure of 52% (IQR 44-59%), and a PVI procedure of 76% (IQR 70-82%).
Conclusions:Graduating GSRs have the greatest competency and autonomy predictions for endovascular AV access and endovenous procedures when compared to the other endovascular procedure categories. However, graduating GSRs approach competence and meaningful autonomy in PVI procedures. These findings suggest that enhanced training in these cases could support a general surgery workforce able to serve a select group of vascular surgery patients.
Back to 2025 Abstracts
