Although pediatric surgery is 1 of the American Board of Surgery (ABS)’s ten required content areas of general surgery training,1 educators have little guidance about pediatric surgery curricula. This leads to inconsistencies across programs. A recent analysis of general surgery residency programs’ block rotation schedules found significant variation in the timing, structure, duration, and setting of residents’ pediatric surgery experiences.2 This variation in residents’ educational experiences is problematic in ensuring residents achieve the same learning outcomes. Suboptimal support for residents may impede their learning, burden other team members, and compromise patient safety both during their rotations and in the long term.3

Decades of research on the topic indicate that while surgical residents find their pediatric surgical experiences to be educationally worthwhile, only a small fraction of residents anticipate actually operating on pediatric patients during their careers.4, 5, 6, 7 It remains to be seen how this number may be affected by the Accreditation Council for Graduate Medical Education (ACGME)’s recent approval of Joint Surgery/Pediatric Surgery residency programs which provide an alternative path for trainees who are interested in advanced training.8 However, up to 40% of pediatric surgical procedures occur at adult hospitals,9 so adult general surgeons are important contributors to pediatric surgical care.10,11 Thus, it is important to ensure that all surgical residents are gaining the maximum educational benefit possible in what may be their only opportunity for pediatric surgical training.

Given the importance of the pediatric surgery rotation during general surgery training, this study aims to characterize the learning environment for general surgery residents on pediatric surgery rotations across the United States, focusing on common educational challenges, and to identify best practices and interventions that can successfully address these challenges. To fully understand the areas for improvement, we sought the perspectives of residents as well as pediatric surgical team members including faculty, fellows, and advanced practice providers (APPs). By conducting this needs assessment, our goal is to help promote a shared understanding between residents and educators on pediatric surgical rotations and highlight opportunities to enhance the learning environment.