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October 14, 2009

Shared Accountability, Appropriateness, and Quality of Surgical Care

Author Affiliations

Author Affiliations: Dr Zeller is Contributing Editor and Dr Fontanarosa ( is Executive Deputy Editor, JAMA.

JAMA. 2009;302(14):1590-1591. doi:10.1001/jama.2009.1495

For a quarter century, an ongoing dialogue has focused on the integrity of the surgical residency training curriculum. The complexities of resident training, the acquisition of cognitive knowledge and technical skills, the quantification of experience, and intricacies of the certification process have been scrutinized and discussed. As a vital constituent in the health care systems of the rural and urban United States, surgeons have benefited from this dialogue, which has contributed to the standards of the profession. In addition, the varied implications of the economic, technological, and workforce challenges that have confronted every academic and community-based surgeon have likewise resulted in reforms and substantial changes in the evolution of surgical education.1 Despite such a deliberate focus on the training and accreditation of surgeons, there now emerge novel challenges related to national health care reform that undoubtedly will affect the current practice of surgery.

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