LEAH WINER, M.D.

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Researchers analyzed case logs from 1,343 general surgery graduates across 20 programs to characterize the training experience of those who pursued a surgical oncology fellowship. Future oncology fellows performed more cancer-relevant operations — particularly liver, pancreas, and endocrine cases — and were more likely to train at university-based programs with dedicated oncology faculty and NCI cancer centers. Dedicated research time and institutional NIH funding were the strongest independent predictors of pursuing this fellowship path.

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This study looked at how dermatofibrosarcoma protuberans (DFSP), a type of skin cancer, is treated across different countries and what the outcomes are for patients. Researchers analyzed data from 347 DFSP patients and found that 89.5% were eventually able to have their tumors removed with no cancer left behind (R0 resection), but one in five patients needed additional surgery to achieve this. Importantly, the survival rate for these patients was very high at 98.8% over a median follow-up of nearly four years, showing that with proper treatment, the outlook for DFSP patients is optimistic. Who this helps: This information benefits patients with DFSP and their doctors by providing insights into effective treatment strategies.

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This study looked at how different biopsy techniques for a rare skin cancer called dermatofibrosarcoma protuberans (DFSP) affect patient outcomes. Researchers analyzed data from 321 patients and found that those who had a preoperative biopsy had better results: 78.6% achieved a successful removal with clean margins compared to 60.1% of those who had an excisional biopsy, and fewer complications occurred with preoperative biopsy (25.6% versus 38.2%). These findings matter because they suggest that preoperative biopsies may lead to easier and safer surgeries for patients. Who this helps: This helps patients diagnosed with dermatofibrosarcoma protuberans and their doctors.

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A multi-institutional analysis of surgical training logs found that residents who went on to pursue breast surgical oncology fellowships performed 50% more breast operations during residency than their peers, despite having similar access to breast surgery rotations. However, these same residents logged fewer total cases across most other surgical domains. The pattern suggests future breast surgeons self-select toward breast cases early in training, with implications for how residency programs should be structured.

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This study looked into why female residents in general surgery get less hands-on experience in the operating room compared to their male counterparts. Researchers found that 22% of women reported facing obstacles that hindered their ability to participate in surgeries, and more than half felt that their gender affected their training opportunities. The findings highlight that sexism and bias are significant barriers, and the residents suggested creating clearer guidelines and feedback systems to ensure fair access to surgical cases. Who this helps: This research benefits female surgery residents and helps ensure fair training opportunities for all genders.

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A post-hoc analysis of training logs from 1,343 general surgery residents identified characteristics associated with landing in the bottom quartile for total operative volume. Low-volume residents were more likely to be female, underrepresented in medicine, and training at low-volume or highly NIH-funded programs. The findings highlight that disparities in operative experience are shaped by both individual and institutional factors that can be targeted for intervention.

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A comparison of operative case logs from 5,482 general surgery graduates and 4,152 practicing surgeons found that resident training closely mirrors real-world practice in core domains like abdominal and alimentary tract surgery. Residents get more experience in subspecialty areas like trauma and vascular surgery due to their training environment, while practicing surgeons do more breast work. The data provide reassurance that surgical training is appropriately aligned with the operations graduates will encounter in practice.

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A survey of 60 residency applicants who interviewed virtually during the 2020-2022 cycles found that 88% came away with a more favorable view of the program after a virtual interview, and factors like resident interactions and program culture were most influential. Half of applicants favored virtual-only interviews, but the majority wanted a hybrid option going forward. Applicants broadly supported capping interview numbers to reduce the burden on applicants and programs alike.

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Across 1,343 general surgery graduates from 20 programs over 11 years, women performed significantly fewer total cases than men, largely due to fewer surgeon junior cases — the core learning role. On multivariable analysis, female sex independently reduced the odds of being a high-volume resident by 26%. The gap appears to be narrowing slowly over time, with women increasing their annual case volume faster than men, but the disparity has not been eliminated.

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Case log data showed that the COVID-19 pandemic reduced general surgery resident case volumes nationally, with 2020 graduates completing about 1.5% fewer total cases and 8% fewer chief-level cases than 2019 graduates. At one institution, residents across all training levels performed 42% fewer operations during peak pandemic months. The magnitude of the impact on training quality and future competency warrants continued monitoring.

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This study looked at patients with rectal cancer who had a complete response to initial treatment and whether they received recommended follow-up chemotherapy. It found that 32% of these patients received chemotherapy after surgery, but those who did had a five-year survival rate of 92% compared to 85% for those who didn’t. This is important because it shows that follow-up treatment can significantly improve survival rates, yet many patients are not receiving it. Who this helps: This helps rectal cancer patients who may need further treatment after their initial therapy.

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This study looked at how different doses of norepinephrine, a medication used to treat critically ill patients, affect survival rates in medical and surgical intensive care units (ICUs). Researchers analyzed data from 661 patients and found that mortality rates increased significantly when norepinephrine doses exceeded certain levels: specifically, a rate above 18 mcg/min or a total dose over 17.6 mg was linked to higher death rates, with trauma patients facing a mortality rate of 41.7% even at low doses of 5 mcg/min. Understanding these dose limits is crucial for doctors to make better decisions about treatment for critically ill patients. Who this helps: This helps doctors treating critically ill patients in ICUs.

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This study looked at how the treatment for pancreatic cancer changed in the U.S. after a key 2004 trial. Between 1998 and 2015, the use of chemotherapy after surgery for pancreatic cancer rose significantly from 2.9% to 51.6%, while the use of chemoradiation dropped from 49.5% to 22.9%. This shift matters because it shows that new research can take time to influence actual treatment practices, even though chemotherapy has proven to be more beneficial for survival than chemoradiation. Who this helps: Patients with pancreatic cancer.

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This study looked at burnout in fellows training to become abdominal transplant surgeons. It found that 22.7% of these fellows experienced burnout, and those with lower resilience were more likely to feel burned out. Burnout led to long working hours, severe stress, a high likelihood of considering quitting, and an increased risk of making medical errors, highlighting the need for better support systems to help these doctors. Who this helps: This helps transplant surgery fellows and their patients by improving surgeon well-being and patient care.

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This study looked at how effective a surgical boot camp was in teaching new interns important surgical skills. After attending eight training sessions, interns became faster and better at tasks like knot-tying and skin closure, with significant improvements in completion times (for example, reducing skin closure time from 9.9 minutes to 8.3 minutes). By the end of the year, they maintained these skills and even got better at certain techniques. Who this helps: This benefits new surgical interns as well as the patients they will treat.

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This study looked at who leads academic general surgery departments and found that leadership is still largely made up of men and white individuals. Out of 118 programs, 79% of department chairs were white and 85% were men, while only a small number of minority surgeons held leadership roles. Addressing these disparities in leadership is important because increasing diversity can lead to better mentorship and improved patient care. Who this helps: This helps patients and aspiring surgeons by promoting a more diverse leadership that can improve mentorship and healthcare outcomes.

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The study looked at complications with bile ducts that can happen after a liver transplant, focusing on how to manage these issues without surgery. Out of 449 patients who had transplants, 21% developed complications, mainly narrowed bile ducts (59%), leaks (29%), or both (12%). When treated endoscopically, most patients saw positive outcomes—94% for narrowed ducts, and 90% for leaks—showing that non-surgical methods can effectively resolve these issues without increasing risks for patients. Who this helps: Patients who undergo liver transplants benefit the most from these findings.

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This study looked at small bowel cancers to see how the location of the tumor affects survival rates. Researchers found that tumors in the duodenum (the proximal area) have worse survival outcomes compared to those in the jejunum and ileum (the distal area). Specifically, patients with proximal tumors were more likely to have aggressive cancer types and a lower chance of survival, while those with distal tumors tended to be larger but were associated with better outcomes when treated with certain chemotherapy options. Who this helps: This information helps doctors understand how tumor location affects patient treatment and survival, guiding better care for cancer patients.

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This research looked at how blood clotting problems in people recovering from sepsis may relate to long-term health issues. It found that patients in intensive care with blood clotting disorders were more likely to face serious complications and higher death rates, with 28-day mortality linked to these abnormalities. Understanding this connection is important as it could help doctors better manage care for sepsis survivors and improve their recovery chances. Who this helps: Patients recovering from sepsis and their healthcare providers.

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This study looked at two different methods of attaching a new liver during transplant surgery: the traditional piggyback method and a newer side-to-side cavocavostomy method. Out of 290 liver transplant patients, those who had the side-to-side method needed fewer blood transfusions and had fewer complications like temporary abdominal closure—2 transfusions compared to 5, and an 8.3% complication rate versus 24.1%. This matters because it suggests that the side-to-side method may be safer and easier for surgeons, potentially leading to better recovery for patients. Who this helps: Liver transplant patients.

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This study looked at the training experience of general surgery residents in the U.S. regarding hepatopancreatobiliary (HPB) surgery, which includes surgeries on the liver, pancreas, and bile ducts, over 27 years. It found that while the number of surgeries residents performed increased—by 30% for biliary surgeries, 33% for liver surgeries, and 27% for pancreatic surgeries—most of these operations were laparoscopic cholecystectomies, which made up 90% of all biliary procedures. This focus on one type of surgery means that trainees may not get enough varied exposure to other important HPB surgeries, which is concerning for their overall training. Who this helps: This helps surgical residents and educators by highlighting the need for a more balanced surgical training experience.

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This study looked at two methods for performing a combined liver and kidney transplant: the en bloc technique, where both organs are transplanted together, and the traditional method, where they are done separately. The researchers found that patients who received the en bloc transplant had a shorter time for the kidneys to be without blood supply and a quicker surgery, which could mean less risk during the operation. Overall, the outcomes were similar for both methods, with about 88% of en bloc kidney grafts surviving for a year. Who this helps: This research benefits patients needing a liver and kidney transplant, as it provides options that may lead to better surgery experiences.

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This study explored how interest in surgery affects medical students' performance during their surgical training and their future career choices. Out of 62 students surveyed, 51.6% were interested in surgery, with no minority students expressing that interest, compared to 51.1% of Caucasian and 71.4% of Asian students. Students who were not interested in surgery experienced more emotional exhaustion, scoring 25 on average compared to 20 for interested students, but there was no significant difference in their grades. Who this helps: This information benefits medical schools and educators by highlighting the importance of fostering interest in surgery among all student groups.

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This study looked at how burnout affects general surgery residents over their training from 2015 to 2018. Researchers found that burnout levels were highest during the first and third years of residency, with the risk of burnout significantly increasing during the third year (nearly 12 times more likely). Additionally, residents who experienced burnout had lower grit scores, which measure perseverance and resilience. This research highlights the importance of addressing burnout in training programs to better support surgical residents and their well-being. Who this helps: This helps residents and residency programs aiming to reduce burnout and improve training experiences.

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This study looked at whether the photos applicants provide when applying for surgical residency programs influence selection decisions. Researchers analyzed 422 applications from 2018-2019 and found that certain factors like research experience and the overall photo score impacted interview invitations, but interestingly, the applicants' looks did not affect final selection. Specifically, scores for a photo's perceived professionalism significantly correlated with getting interviews, but this was less influential in final decisions, indicating that while appearance plays a role, other qualifications are ultimately more important. Who this helps: This helps applicants to surgical residency programs by highlighting the importance of qualifications over appearance.

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Medical students who assisted with organ procurements reported the experience was meaningful but lacked any formal educational structure. A survey of students who participated over several years found strong interest in surgery and donation but gaps in knowledge and guidance. The authors call for a standardized curriculum to make procurement education consistent and impactful.

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This study looked at how the medication amitriptyline, commonly used as an antidepressant, affects blood clotting during sepsis, a severe infection. The researchers found that in mice with sepsis, amitriptyline treatment prevented dangerous changes in blood coagulation that typically occur, keeping their coagulation levels similar to healthy mice. This is important because it suggests that amitriptyline could be a useful treatment for sepsis, potentially reducing complications like excess bleeding or blood clots. Who this helps: This helps patients suffering from sepsis and their doctors by offering a new treatment option.

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This study looked at what factors predict how well medical students perform during their surgery rotation. It found that students who scored higher on their USMLE Step 1 exam and demonstrated more grit, or persistence, were more likely to achieve higher grades. Specifically, students with honors grades were more often individual learners with a grit score of 8.9 compared to 7.5 for others, highlighting the need for better ways to assess students' clinical skills beyond just tests. Who this helps: This information benefits medical educators and program directors looking to support student success in surgery training.

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This study looked at how often patients undergoing liver surgery (hepatic lobectomy) needed blood transfusions at top medical centers between 2011 and 2014. Out of nearly 6,500 patients, over 20% received blood during their hospital stay, with 35% of those needing more than 5 blood units. The findings show that patients who needed more blood had worse outcomes, such as higher chances of being readmitted (23.4% vs. 13.5% for those who didn't need transfusions) and longer hospital stays (9 days vs. 6 days). Who this helps: This information benefits patients and healthcare providers by highlighting the risks associated with higher blood transfusion needs during liver surgeries.

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This study looked at how the location of pancreatic cancer tumors affects treatment outcomes and survival rates. Researchers found that tumors in the head of the pancreas were more likely to be detected at an earlier stage and to be operable compared to those in the body or tail, with 27.9% of head tumors successfully removed versus only about 10.7% of body tumors and 17% of tail tumors. However, even with surgery, patients with head tumors had worse survival rates than those with body and tail tumors, which raises questions about why this is happening. Who this helps: This information is valuable for doctors treating pancreatic cancer and can guide better diagnosis and treatment strategies for patients.

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This study looked at how a severe infection that can lead to persistent inflammation and weakness in the body, called PICS, affects blood clotting in mice. Researchers found that during PICS, mice had much more clot formation in their lungs and worse lung function, specifically showing a nearly sevenfold increase in small blood clots in the lungs and difficulties in breathing. Understanding these clotting issues is important because they could worsen organ damage and failure in patients recovering from severe infections. Who this helps: This helps doctors treating patients recovering from severe infections and potentially improves patient outcomes.

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This study looked at how the drug amitriptyline (AT) can help mice with sepsis, a severe infection that causes widespread inflammation. The researchers found that mice treated with AT had improved survival rates and less lung damage, with a notable decrease in harmful inflammatory markers and an increase in a protective protein called IL-10. Specifically, AT-treated mice showed a significant reduction in certain inflammatory proteins and improved IL-10 levels, suggesting that it could be an effective treatment option for controlling inflammation in sepsis. Who this helps: This helps patients suffering from sepsis and their doctors by potentially offering a new treatment option to reduce inflammation and improve survival.

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This study looked at patients who had a specific type of cancer surgery followed by chemotherapy (HIPEC) to see how often they needed additional surgery due to complications. Out of 141 patients, 15 (about 10.6%) needed early reoperations, typically within 18 days after the initial procedure. Those who had to undergo reoperations faced a longer hospital stay of 19 days compared to 9 days for those who didn't, and they had a much lower overall survival rate after three years (38% versus 72%). Who this helps: This information is useful for doctors and patients as it highlights the risks of complications following HIPEC and the importance of minimizing them for better outcomes.

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This study looked at how often flat epithelial atypia (FEA), a specific breast tissue finding, was misdiagnosed after a type of biopsy called core-needle biopsy. Among 27 biopsies reviewed, only 44.4% were correctly identified as FEA, and some lesions were found to be early (11.1%) or invasive cancer upon further examination. This matters because it highlights the importance of further surgical removal of suspicious findings, as some may turn out to be cancerous or pose a higher risk for developing cancer. Who this helps: This helps patients with breast abnormalities and their doctors by guiding better management decisions.

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This study looked at a treatment called hyperthermic intraperitoneal chemotherapy (HIPEC) for patients at high risk of cancer spreading within the abdomen. Researchers followed 37 patients for over five years and found that 77% were free from cancer recurrence after five years, while all patients survived, indicating the treatment was both safe and effective. This matters because it provides a promising option for patients who are at high risk of their cancer progressing after surgery. Who this helps: Patients with high-risk abdominal cancers.

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This study looked at the burnout levels of third-year medical students during their surgery training and whether it affected their performance. The researchers found that 22.6% of students reported burnout before the training, which dropped to 17.7% after, but this change wasn’t significant. Students who experienced burnout had lower "grit" scores, indicating they may have less perseverance, yet overall, burnout did not negatively affect their performance or experiences in the program. Who this helps: This research benefits medical students and educators by highlighting the importance of resilience while not increasing concerns about burnout affecting their training performance.

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This study looked at how the surgical training for general surgery residents in the U.S. has changed from 1990 to 2018, focusing on their roles as first assistants and teaching assistants during surgeries. The research found that the number of surgeries where residents acted as first assistants dropped from 21.8% to just 2.5%, and as teaching assistants from 7.4% to 3.5%. This is significant because it shows a concerning decline in hands-on surgical experience for trainees, which is crucial for their skills development. Who this helps: This benefits medical educators and the surgery residency program, ensuring they can maintain effective training standards for future surgeons.

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This study looked at how the surgical training experiences of medical residents have changed over the past 25 years, specifically comparing open surgery to laparoscopic (minimally invasive) surgery. Between 1994 and 2018, over 26,000 surgical residents graduated, and while they collectively performed around 955 major surgeries each, the study found an increase of nearly 10 laparoscopic surgeries performed each year and a decrease of over 3 open surgeries per year. This shift is important because it raises concerns that new surgeons may not be getting enough experience with open surgeries, which could be needed in more complex cases. Who this helps: This benefits surgical residents and their future patients by highlighting the need for balanced training in different surgical techniques.

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This study looked at how a mandatory online learning program for surgical residents, called "This Week in SCORE" (TWIS), affected their test scores and overall well-being. After making TWIS participation required, the average test scores on the American Board of Surgery In-Training Examination increased from the 65th percentile to the 77th percentile, and satisfaction with the learning environment improved significantly. These findings suggest that structured learning and regular assessments can lead to better performance and reduced feelings of burnout among surgical residents. Who this helps: This benefits surgical residents and their education programs.

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This research studied how the amount of fluid given to patients after surgery affects the risk of developing pancreatic fistulas—a complication after pancreatic surgery. Among 104 patients who underwent the surgery, 17.3% developed this complication. The findings showed that patients who received a lot of fluid in the first 72 hours after surgery had a higher risk of developing pancreatic fistulas (31.4%) compared to those with lower fluid levels (11.4% for medium and 8.8% for low fluid balance). Who this helps: This helps doctors in managing fluids for patients undergoing pancreatic surgery to reduce the risk of complications.