A Needs Assessment for Surgical Anatomy Curriculum

Over the past twenty years, the exposure of medical students to anatomy has decreased. Whereas surgical anatomy is fundamental to safe and proficient surgical practice, its adequate teaching and integration into residency programs are lacking. The study sought to identify key surgical procedures in which surgical anatomy is important and challenging for residents through a survey of faculty and residents. The goal was to develop a comprehensive surgical anatomy curriculum for residency training. An anonymous survey was distributed via Qualtrics to a convenience sample of general surgery program directors across the United States. The survey queried respondents on the importance and perceived difficulty of anatomy for each of the twenty identified procedures. Respondents were also prompted to suggest additional procedures. Faculty respondents overwhelmingly emphasized the importance of anatomical knowledge for all procedures except small intestinal resection. Agreement ranged from 97.5% for hepatic segmentectomy/lobectomy to 72.5% for appendectomy. Procedures such as inguinal and femoral repair, vagotomy and drainage, and anal sphincterotomy were deemed extremely important by virtually all faculty respondents. Faculty rated nine procedures as particularly challenging in terms of anatomy, with hepatic segmentectomy/lobectomy being the most difficult (mean difficulty 4.06). Residents also identified four procedures as notably difficult, including hepatic segmentectomy/lobectomy, vagotomy and drainage, and distal pancreatectomy. The findings underscore the critical role of surgical anatomy in procedural competency. Nine procedures were highlighted as both important and difficult, suggesting areas for focused curriculum development. Tailored educational interventions are needed to enhance residents' understanding of anatomy in these specific procedures, ultimately improving patient outcomes and surgical proficiency. Future efforts should focus on implementing and evaluating targeted curricular interventions to address identified gaps in surgical anatomy education. The next step is to develop a curriculum to help residents learn the anatomy of these nine procedures in depth.