Mastery in General Surgery Program helps recent graduates build confidence through experience

Talitha Brown, MD
Talitha Brown, MD

Following residency, Talitha Brown, MD, made the decision to pursue general surgery. She was looking for a community practice and an opportunity that would allow her to shake that “fresh out of residency” look and feel.

Cue the recently renamed American College of Surgeons (ACS) Mastery in General Surgery Program, which was developed by the Division of Education to provide Junior Associates opportunities to build expertise in general surgery based on their specific career goals, learn the business-related aspects of surgical practice, and gain practical experience to launch their careers. Program directors and participants discussed their experiences with the program during Tuesday’s session, Supporting Successful Transition to Independent Practice: Mastery in General Surgery Program.

The program was originally called Transition to Practice (TTP), but because many believed it to be a remedial program, the ACS rebranded it to better emphasize what the program represents: mastery in the field of general surgery. Since the name change, there has been an uptick in applicants, noted session moderator J. David Richardson, MD, FACS, professor of surgery and vice-chairman, Hiram C. Polk, Jr., MD Department of Surgery, University of Louisville School of Medicine, KY, and Past-President of the ACS.

Before the rebrand, Dr. Brown enrolled in the TTP program at Wake Forest Baptist Hospital, Winston-Salem, NC, because it aligned with her career goals, including getting more exposure with burn patients. “I wanted to upgrade some of the procedures I felt comfortable doing from just comfortable to being competent and proficient,” she said.

During her time in the program, Dr. Brown completed 387 cases alone in the operating room, including bread-and-butter general surgery, endoscopy, and complex general surgery. “When I completed the program, I felt fortified in my independent decision making,” she said. “When I started my new job, I started on a Monday and I was on call Tuesday, then Friday, Saturday, Sunday, and I didn’t bat an eye. I felt confident that I was able to take care of my patients. I didn’t need to call any help. I knew what I was doing.”

The impetus for the program was the concern among newly graduated general surgeons about a lack of preparedness for practice, Dr. Richardson said. To date, 51 surgeons have completed the program and more than half have been offered jobs at their home institution.

Brooke M. Buckley, MD, FACS, chief medical officer, Meritus Health, Annapolis, MD, described her experiences implementing the Mastery in General Surgery Program at the Anne Arundel Medical Center, Annapolis, MD. In the early days, she said the program went through some growing pains as elements were flushed out, including mentoring.

“Our ability to get our fellows [practicing] independently has enhanced and increased over the years,” Dr. Buckley said. “The first year, there was a lot of oversight because we had to convince the operating room and fellow surgeons that this was a good idea—that it was not remediation, that this was something they were capable of doing, and in any other setting, this is something they would already be doing.”

The program at Anne Arundel Medical Center includes time in acute care surgery service and electives, which could include rural, gastrointestinal, and surgical oncology, she said. “We’ve had a lot of things happen that we really weren’t expecting by trying this experiment,” Dr. Buckley said. “Number one, in trying to develop a new program for graduates, we developed ourselves.”

Halle Beitollahi Ellison, MD, FACS, a participant in the Mastery in General Surgery Program at Geisinger Medical Center, Danville, PA, touted the benefits of being able to tailor the program and gain more surgery experience.

“We have a lot of experience in residency doing more complex cases, but not when it comes to the bread-and-butter general surgery we’re going to be doing out in the community. At least in my case, that’s where the confidence was lacking,” she said.