Surgery interns' experience with surgical procedures as medical students.

Instruction in the technical aspects of surgery begins in medical school. To identify areas of inexperience among incoming interns, we asked 40 first-year residents to indicate which bedside and emergency room procedures and operations (or parts of operations) they had performed in medical school and to rate how confident they were in performing those procedures as a result of their experiences. Respondents indicated that placement of nasogastric tubes, Foley catheters, and central lines were procedures they commonly performed (78.4% to 97.3%); they less frequently placed arterial and pulmonary arterial lines and chest tubes (21.6% to 64.9%). Many students had opportunities to assist in closure of incisions in actual operations (60%), but only 22% performed other parts of operative procedures. Opportunities to perform procedures did not correlate with the length of time spent on surgical rotations. Nearly half (49%) participated in animal surgery laboratories as part of their surgical rotation. These findings suggest that many interns have not performed some basic procedures by the time they enter their residency. Instruction in technical skills in clinical medicine, frequently surgical, represents a deficiency in medical school curricula. The general inexperience of surgical interns in performing these procedures must be remembered when assigning these duties.