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In This Issue of JAMA Surgery
October 2016


JAMA Surg. 2016;151(10):893. doi:10.1001/jamasurg.2015.2946


Kibbe et al characterize the status of mentorship programs in US departments of surgery. A survey was sent to 155 chairs of departments of surgery regarding the presence and structure of the mentorship program in their department. Seventy-six of 155 chairs responded to the survey, resulting in a 49% response rate. Forty-one of 76 department chairs (54%) self-reported having an established mentorship program. Data from the survey show that only half of departments of surgery have established mentorship programs, and most are informal, unstructured, and do not involve all of the key stakeholders.

Invited Commentary


Safety-net hospitals care for vulnerable patients, providing complex surgery at increased costs. Go and colleagues modeled different techniques for reducing the cost of complex surgery performed at safety-net hospitals and found that redirecting patients away from safety-net hospitals for complex surgery may represent the best option for reducing costs.

Invited Commentary

Both medical and revascularization interventions for intermittent claudication (IC) aim to increase walking comfort and distance, but there is inconclusive evidence of the comparative benefit of revascularization given the possible risk of limb loss. Devine et al compare the effectiveness of a medical vs revascularization intervention for IC. They found that patients with IC in the revascularization cohort had significantly improved function, better health-related quality of life, and fewer symptoms at 12 months than patients in the medical cohort.

Invited Commentary and Related Article

Clinical Review & Education

Primary hyperparathyroidism is a common clinical problem for which the only definitive management is surgery. Wilhelm et al developed evidence-based guidelines to enhance the appropriate, safe, and effective practice of parathyroidectomy. A multidisciplinary panel used PubMed to review the medical literature from January 1, 1985, to July 1, 2015. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus.

Invited Commentary

Author Audio Interview and CME

Pulcrano et al systematically review the literature across multiple surgical specialties and provide a comprehensive understanding of quality of life (QOL) and burnout among surgeons, delineate variation in rates of burnout and poor QOL, and elucidate factors that are commonly implicated in these outcomes. They found that burnout and QOL vary across surgical specialties. Residents are at an increased rate for burnout and more likely to report a poor QOL than attending surgeons. It is unclear whether sex affects burnout rates.