Background Some patients have concerns regarding. the impact of surgical tr
ainees on the quality of care that they receive in teaching hospital. No po
pulation-based data exist that describe outcomes of surgical procedures in
teaching and nonteaching hospitals; however institutional data suggest that
teaching hospital provide high-quality care. We hypothesized that the pres
ence of a general surgery residency program (GSRP) is associated with super
ior outcomes for Pancreatic resection, a complex surgical procedure.
Methods. A retrospective, population-based, risk-adjusted analysis of 5696
patients who underwent major pancreatic resection compares the outcomes of
patients treated at hospitals with a GSRP (GSRP+) and those hospital withou
t a GSRP (GSRP-).
Results. GSRP+ hospitals had a lower operative mortality rate (8.3 % vs 11.
0 %; P < .001), a lower percentage of patients discharged to another acute
care hospital or skilled nursing facility (6.5% vs 13.0%; P < .001), and a
longer length of stay compared with GSRP- hospitals (22.1 +/- 0.4 days vs 1
9.6 +/- 0.3 days; P < .001). The observed difference in hospital mortality
rates was not significant after an adjustment was made for patient mix and
hospital volume (9.7% vs 10.0%). However outcomes were found in the univers
ity teaching hospitals, as compared with the affiliated teaching and the no
nteaching hospitals (5.3% [P < .001] vs 11.4% vs 21.0%; risk adjusted, 8.0%
[P < .05] vs 10.9% vs 10.0%).
Conclusions. The presence of surgical trainees does not have an adverse imp
act on the quality of care for One complex procedure, pancreatectomy and is
associated with superior operative mortality rate in university teaching h