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December 1990

Resident Training

Author Affiliations

Denver, Colo

Arch Surg. 1990;125(12):1630. doi:10.1001/archsurg.1990.01410240114023

To the Editor.—In the April 1990 issue of the Archives, Doerr et al1 reviewed a 10-year experience with pancreaticoduodenectomy at four teaching hospitals of the State University of New York, Buffalo. There were 61 cases, an average of six per year and 1.5 per hospital per year. Fifty-five residents performed one pancreaticoduodenectomy during their training; three residents did two such procedures. Operative morbidity and mortality were an acceptable 36% and 8%, respectively. The authors conclude that these results justify preserving pancreaticoduodenectomy as an important part of surgical training. Training for what? Such limited experience hardly connotes expertise; it arguably fails to impart even competence. Furthermore, as noted by Barnes2 in the same issue, 60% to 75% of present general surgical graduates go on to other fields (eg, cardiothoracic surgery and plastic surgery). Few of the latter are likely to perform complex pancreatic surgery again, yet they receive