Abstract
This study examined training methods for acute care surgeons by comparing such methods between an urban emergency critical care center and the surgical department of a regional core hospital, both of which were assumed to be involved in acute care surgery at the time of the study. The conditions of surgical practice were retrospectively investigated at the Department of Critical Care Medicine and Traumatology of the National Hospital Organization National Disaster Medical Center, where first author was then affiliated, and the Department of Surgery of Iwaki Municipal Iwaki Kyoritsu Hospital, where first author was previously affiliated. Regarding surgery, the annual number of surgical cases performed by each young surgeon was 85 at the National Disaster Medical Center and 155 at the Department of Surgery of Iwaki Kyoritsu Hospital. The modalities of surgery also varied more widely at the latter. Regarding surgical critical care, the numbers of experiences with mechanical ventilation support, hemodiafiltration, and open abdominal management were all larger at the National Disaster Medical Center. The annual number of trauma surgeries performed by each young surgeon was small at both the National Disaster Medical Center and Iwaki Kyoritsu Hospital, being 16.0 and 3.2, respectively. As a training site for acute care surgeons, surgical departments of regional core hospitals provide fewer opportunities to experience surgical critical care while the variation of surgical modalities experienced by young surgeons is limited at urban emergency critical care centers. Thus, exchange and other programs for young surgeons between institutions should be considered. Because experiences with trauma surgery are limited at both types of institution, training for trauma surgical procedures is an issue.
