(HealthDay News) — Nonuniversity-based residency (NUBR)-trained surgeons and university-based residency (UBR)-trained surgeons have distinct practice patterns, according to a study published online Jan. 10 in JAMA Surgery.

Morgan M. Sellers, MD, from the Hospital of the University of Pennsylvania in Philadelphia, and colleagues conducted an observational cohort study to examine the differences in practice patterns and clinical outcomes for surgeons trained in NUBR and UBR programs. Practice pattern analysis was performed for 3,638 surgeons with 1,237,621 patients, representing a total of 214 residency programs. Data from 2,301 surgeons and 312,584 patients were included in clinical outcomes analysis.

The researchers found that NUBR-trained surgeons performed more procedures than UBR-trained surgeons (median, 328 vs 164) and performed a greater proportion of procedures in the outpatient setting (risk difference, 6.5). Compared with UBR-trained surgeons, NUBR-trained surgeons had a significantly lower proportion of patients with documented inpatient mortality before matching (risk difference, −1.01). NUBR-trained surgeons also had significantly lower mean proportion of patients with complications (risk difference, −3.17) and prolonged length of stay (risk difference, −1.89%). No significant differences were seen between NUBR- and UBR-trained surgeons in patient mortality, complications, and prolonged length of stay after matching.

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“Surgeons trained in NUBR and UBR programs have distinct practice patterns,” the authors write. “After controlling for patient, procedure, and hospital factors, no differences were observed in the inpatient outcomes between the two groups.”


Sellers MM, Keele LJ, Sharoky CE, et al. Association of surgical practice patterns and clinical outcomes with surgeon training in university- or nonuniversity-based residency program. JAMA Surg. 2018 Jan 10. doi: 10.1001/jamasurg.2017.5449