Impact of Research Training on Performance in General Surgery Residency

INTRODUCTION: It is common for North American surgical trainees to interrupt clinical training to complete 2 or more years of research training. The impact of this practice on surgical aptitudes is unknown. The University of Toronto has large general surgery and surgeon scientist training programs. We compared the examination scores of general surgery residents in continuous clinical training with those of residents whose training was interrupted by research. METHODS: We collected anonymized scores obtained at written and oral annual in-training examinations by general surgery residents at the University of Toronto from 2011 to 2016, inclusive. The written exam assessed knowledge, while the oral exam assessed judgment. Residents were dichotomized into continuous versus non-continuous clinical training streams. We compared performance prior to, during, and following divergence for research training both within and between the 2 groups. RESULTS: At the junior resident level, future enrollment in research training was associated with higher examination performance (P-written=.003). Annual scores plateaued during research training, while scores of residents who continued in continuous clinical training improved year over year (P-written=.009). Non-continuous stream resident exam scores remained stagnant after 1 year then improved in the second year after return to clinical training (P-written=.00007). Scores obtained in the final year of residency training did not significantly differ between residents who underwent continuous versus non-continuous clinical training. Results from written and oral exams trended concordantly. CONCLUSIONS: We demonstrate that interruption of clinical training for 2 or more years of research is associated with a stagnation of performance on annual in-training examinations assessing both knowledge and judgment. This phenomenon is followed by an eventual catching-up after at least 2 years return to full-time clinical training. This may inform residency program curriculum design. (C) 2021 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved