Intern perceptions of preparedness to manage common clinical scenarios and perform procedures in general surgery were serially surveyed in academic years ending in 2011 and 2012 based on the Residency Review Committee supervision guidelines.
Interns felt less prepared across all measured domains from 2011–2012. Interns felt significantly less prepared to manage hypotension (3.00/4 points to 2.67/4 points; P = 0.04), place a tube thoracostomy (2.45/4 points to 1.92/4 points; P = 0.04), or perform an inguinal hernia repair (1.91/4 points to 0.92/4 points; P = 0.01) without supervision. Interns were also significantly less likely to agree that they were able to gain clinical skills based on experience (4.31/5 points versus 4.15/5 points; P = 0.02). Longitudinal analysis throughout internship demonstrated improved preparedness to manage common clinical problems and perform procedures between the second and the fifth months of internship.
First-year residents after July 2011 felt less prepared in the topics surveyed than those before July 2011. Interns made the greatest gains in preparedness between months 2 and 5, suggesting that despite planned interventions, no substitute currently exists for actual clinical experience. Planned educational interventions to improve intern preparedness are also indicated.