Table 3: Postgraduate year Training Levels and Numbers of Procedures Type of procedure Residents Fellows Residency Fellowship Procedures (n) Skill levela Procedures (n) Skill levela Procedures (n) Skill Levela LRYGB 20 (0-100) C (A-E) 38 (0-200) D (B-D) 150 (5-375) D (B/CD/E) OAGB 0 (0-30) C (A-D) - - - 0 (0-18) - - LSG 8 (0-40) C (B-E) 14 (0-60) D (D) 14 (5-51) D (D-E) Open RYGB 0 (0-5) B (A-D) - - - 0 (0-1) D (D) Lap gastric banding 0 (0-10) A (A) 18 (0-50) - - 5 (0-50) - - Lap band removal 4 (0-20) C (A-D) 0 (0-100) D (C-D) 16 (3-70) D (D) Revision procedures 0 (0-30) D (B-E) 0 (0-15) E (D-E) 11 (0-75) D (D) Duodenal switch 0 (0-1) B (A-D) 0 (0-21) D (C-D) 0 (0-5) D (D-D/E) Total 40 (0-148) 93 (25-275) - - 220 (5-306) - - (L)RYGB = (laparoscopic) Roux-en-Y gastric bypass, LSG = laparoscopic sleeve gastrectomy, OAGB = one-anastomosis gastric bypass, Postgraduate year (PGY) training levels and numbers of procedures performed as reported by surveyed residents and fellows. Data are displayed as median (range) a Skill level: A: assisting; B: under strict supervision; C: under limited supervision, D: without supervision; E: supervising At the time of interview, most residents had reached level of supervision C (performing surgery under limited supervision). One resident had reached level A (assisting; 5%), three level B (strict supervision, 16%), twelve level C (limited supervision, 63%), two level D (without supervision, 11%) and one was supervising LRYGB (5%). Six out of eight fellows were able to perform the operations without supervision (75%), one as supervisor (12.5%), and one performed LRYGB under limited supervision (12.5%). Eight residents were able to perform LSG resections without supervision. Scientific Meetings and Courses Six respondents reported having visited meetings of the Dutch Society for Metabolic and Bariatric Surgery (DSMBS) and nine respondents had joined congresses of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). Other reported meetings were advanced laparoscopic suturing courses and medical-industry driven 50 3
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