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Early career surgeon performance - a patient safety blind spot

Award Number: K08HS027653
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 04/01/2021
PERIOD OF PERFORMANCE END DATE: 03/31/2026

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Early career surgeon performance - a patient safety blind spot - Project Summary/Abstract A recent multi-institutional study suggested that graduating general surgery trainees could not independently perform common operations over 20% of the time. These findings raise serious concerns about the readiness of early career surgeons to provide safe, high-quality surgical care. The degree to which these training deficiencies compromise patient safety is unknown. A better understanding of the relationship between surgical training, surgeon performance, and patient outcomes is needed to effectively tackle these issues. Ultimately, we must update the standards that must be met by all surgical trainees prior to graduation. There are, however, several knowledge gaps that must be addressed before the full potential of this approach can be realized. The purpose of this proposal is to close those gaps and map a policy response moving forward. The specific research aims of this proposal are to (i) determine the operative performance of early career surgeons assessed using risk-adjusted outcomes in national Medicare claims data; (ii) determine if a surgeon’s trainee performance ratings are valid predictors of their early career risk-adjusted patient outcomes; and (iii) determine if initial certification of surgeons immediately after training reliably discriminate early career surgeon performance. This study will, for the first time, determine the degree to which early career surgeon competence impacts health care quality and whether existing measures of trainee competence are useful predictors of early career performance. The results of this study can ultimately be used to implement new training standards to ensure that all early career surgeons are competent. These changes are urgently needed to safeguard the health of millions of American patients. This project will also facilitate the career development of the candidate. The highly experienced and multidisciplinary mentorship team, the proposed career development and research plan, and the unparalleled research environment are ideally suited to address the career goals and educational needs of the candidate PI, Brian George, MD, MA. Although he has substantial prior experience assessing surgical trainee performance, he has no experience using Medicare claims data to assess risk-adjusted outcomes. These skills are necessary for him to achieve his goal of ensuring that all early career surgeons provide safe care. This proposal therefore includes additional training which will be essential both for the successful completion of this research and for Dr. George’s career development, including graduate level courses in Medicare claims data analysis, the use of risk-adjusted outcomes for performance measurement, and advanced statistical modeling. This career development award will lay the groundwork for Dr. George to mature as an independent investigator and national leader in understanding how to ensure all surgeons provide safe care when they enter practice.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $143,640 )
2025	2025	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE STE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	3/25/2025	NON-COMPETING CONTINUATION	$143,640
														Subtotal = $143,640

Issue Date FY: 2024 ( Subtotal = $140,850 )
2024	2024	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE, SUITE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	3/13/2024	NON-COMPETING CONTINUATION	$140,850
														Subtotal = $140,850

Issue Date FY: 2023 ( Subtotal = $148,111 )
2023	2023	REGENTS OF THE UNIVERSITY OF MICHIGAN	503 THOMPSON STREET	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	3/29/2023	NON-COMPETING CONTINUATION	$148,111
														Subtotal = $148,111

Issue Date FY: 2022 ( Subtotal = $148,111 )
2022	2022	REGENTS OF THE UNIVERSITY OF MICHIGAN	503 THOMPSON ST	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	3/18/2022	NON-COMPETING CONTINUATION	$148,111
														Subtotal = $148,111

Issue Date FY: 2021 ( Subtotal = $148,111 )
2021	2021	REGENTS OF THE UNIVERSITY OF MICHIGAN	503 THOMPSON ST	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	3/23/2021	NEW	$148,111
														Subtotal = $148,111

Grand Total All Awards = $728,823

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Early career surgeon performance - a patient safety blind spot

Award Number: K08HS027653

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 04/01/2021

PERIOD OF PERFORMANCE END DATE: 03/31/2026

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