Attainment of Surgical Competence in Otolaryngology Training

Abstract

Objective: Determine postgraduate year (PGY) at which competence is achieved in key otolaryngologic procedures as reported by residents and program directors (PDs) and evaluate relationship between resident and PD perceptions.

Method: Cross-sectional survey of residents and PDs in US otolaryngology residencies conducted in 2011 using surveymonkey.com, assessing attainment of competence by residents for 32 otolaryngologic procedures. PGYs at which competence is achieved per residents and PDs were determined using linear regression models, and associations were assessed with chi-square goodness-of-fit test.

Results: A total of 277 residents (19.45%) and 39 PDs (37.86%) completed surveys. Compared with PD perceptions, residents felt they achieved subjective competence earlier than expected by PDs for 13 of 32 procedures, later than expected by PDs for 3 of 32, and at the same PGY for 16 of 32 (significance at P < .05 level by pooled t test) . Degrees held, fellowship plans, and size of residency program did not significantly impact PGY at which residents felt competence was achieved for most procedures.

Conclusion: We provide baseline data on PGY at which residents achieve competence in key otolaryngologic procedures. These results may guide efforts to establish appropriate milestones for resident training and assessment and better structure resident operative experiences.