My daughters has their surgery at a teaching hospital and so a junior person assisted the surgeon each time. There was no issue with the operations in either case.

Effect of Spine Fellow Training on Operative Outcomes, Affirming Graduated Responsibility

Lonner, Baron S.; Toombs, Courtney S.; Hammouri, Qusai; More

Spine., POST ACCEPTANCE, 18 July 2013

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Study Design. Retrospective review of prospectively collected surgical data

Objective. This study sought to determine the effect of fellow education over the course of the academic year (August - July) on surgical outcomes in adolescent idiopathic scoliosis (AIS). One surgeon and one type of surgery were chosen to minimize confounding factors.

Summary of Background Data. Educating and training the next generation of physicians and surgeons is necessary for the survival and continuation of medical care. There has been recent momentum to scientifically document that medical education is safe. Spine surgery is complex and demanding, with a steep learning curve making it an ideal model to detect any potential negative impact of medical education.

Methods. Subjects: adolescent patients undergoing posterior spinal surgery, between August 2007-July 2010, by a single senior surgeon at one institution with a fellow as the only surgical assistant. Demographic and perioperative data were collected then segmented by surgical date into quarters according to the rotations of the academic year. One fellow was included in each quarter over four years, resulting in 16 fellows across the four quarters. An ANOVA was used to assess differences in operative time, blood loss, length of stay and complications between the quarters of the year.

Results. There were no significant differences between the groups regarding age, sex, or Lenke curve type. No statistically significant differences were found between the four quarters of the fellowship year for estimated blood loss, use of cell saver, length of stay, operative time, and complication rate.

Conclusions. This study is the first to show that fellow education over the course of the academic year did not impact the patient outcomes studied. It is clear that while there is significant academic benefit for the fellows as they complete their spine fellowship, there is no negative impact for patients.

(C) 2013 by Lippincott Williams & Wilkins