Coturel A. Editorial:Inserción laboral del cirujano joven. Rev Argent Cirug 2021;113(1):5-8
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Gregorio Araoz Alfaro). Then, in 1957 the first university
surgery residency was created at Hospital Durand .
The Naꢀonal Ministry of Health delegates the
accreditaꢀon process of general surgery residencies
3
Over 100 years have passed and the advances to Asociación Argenꢁna de Cirugía. The aim of this
in technology and telecommunicaꢀons have generated process is to ensure the quality of the programs already
deep changes in society and surgical pracꢀce, which running and to promote improvement in general
would result in changes in training models.
surgery residency programs at the naꢀonal level. Only
The generaꢀon that is currently in the process 44 (25%) of the insꢀtuꢀons idenꢀfied in the census are
8
of training, the millennials, seek to achieve a balance currently accredited . This means that we ignore the
betweenworkandlife, soitisdifficultforthemtochoose training program of 75% of the residencies naꢀonwide
specialꢀes such as general surgery which requires long and if this program complies with the general guidelines
hours in the operaꢀng room, great physical demands, proposed by the associaꢀon.
4
long training period and less autonomy . In turn, the
During the census, we asked all the insꢀtuꢀons
way this generaꢀon learns is different from the way to send us the list of current residents and graduate
those who are currently in charge of teaching and trainees and had a response rate of 92%. Between
5
producing residency programs did so . This gap generates 2015 and 2020 at least 1611 physicians completed the
a conflict where the different actors do not seem to residency program; 621 (39%) were women. We know
understand each other.
that other surgical specialꢀes use the general surgery
In addiꢀon, the proporꢀon of women who residency as a bridge in their training; therefore, in a
choose surgical training is increasing, and this is not second stage of the census we tried to respond how many
a minor fact. While there are no sex differences that of these graduate trainees were sꢀll pracꢀcing general
prevent women from performing surgery as good as surgery or its branches.
or beꢄer than men, the training period occurs during a
We conducted a survey among members of
woman’s reproducꢀve years. A pregnant resident is sꢀll Asociación Argenꢁna de Cirugía < 40 years to tackle
frowned upon, and many of us were even discriminated the problem of general surgeons’ working condiꢀons.
against from some posiꢀon just because we might have We obtained 155 responses; mean age of survey
children in the future. This is not limited to the training respondents was 35 years and 72% were men. Fiꢃy-six
period; in a survey of female surgeons, 46% of those percent had been chief residents and 77% were either
who did not have children stated that motherhood compleꢀng or had already finished a subspecialty.
was not compaꢀble with their working life, while 69% The most chosen subspecialꢀes were colon and
of those who already had children had to change their rectal surgery, hepato-pancreato-biliary surgery, and
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working style . Some publicaꢀons reported a lack of gastroesophageal surgery. Most of the young surgeons
confidence to perform surgical procedures among who responded the survey were pracꢀcing in the
graduaꢀng general surgery residents. This could be due Autonomous City of Buenos Aires, the Province of
to duty hour restricꢀons, decreased autonomy, greater Buenos Aires, or both.
operaꢀve complexity, and social and poliꢀcal factors.
Fiꢃy-two percent of the respondents were
However, this is a maꢄer of debate, since most surveys both employees and self-employed, indicaꢀng that
are subjecꢀve and the topic had not been explored unꢀl they had more than one job, and 53% worked 60
7
2
003, so there are no data from previous generaꢀons .
hours per week or greater. Mulꢀple job-holding and
During 2020, the Commiꢄee of Young Surgeons excessive workloads are detrimental to the conꢀnuing
of Asociación Argenꢁna de Cirugía started a naꢀonal educaꢀon of young surgeons and to their quality of life.
census to idenꢀfy general surgery residents who had In addiꢀon, as 84% of the respondents considered that
graduated within the last 5 years. During that process, they were not well paid, general surgery does not seem
we idenꢀfied 178 insꢀtuꢀons with acꢀve general to be an aꢄracꢀve specialty to choose nowadays.
surgery programs. There are training centers in 21
We can conclude that the problems of our
provinces, and 77% of them correspond to the Province specialty are related with mulꢀple factors and that all
of Buenos Aires, the Autonomous City of Buenos Aires, the actors must be included to solve them. Charles
Córdoba and Santa Fe. The posiꢀons are in public Darwin said: “It is not the strongest of the species that
(
naꢀonal, provincial and municipal), university and survives, nor the most intelligent that survives. It is the
private insꢀtuꢀons corresponding to high and medium one that is the most adaptable to change”. This is the
complexity centers. opportunity for surgery to change.