# Early career surgeon performance - a patient safety blind spot

> **NIH AHRQ K08** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2021 · $148,111

## Abstract

Project Summary/Abstract
A recent multi-institutional study suggested that graduating general surgery trainees could not independently
perform common operations over 20% of the time. These findings raise serious concerns about the readiness
of early career surgeons to provide safe, high-quality surgical care. The degree to which these training
deficiencies compromise patient safety is unknown. A better understanding of the relationship between surgical
training, surgeon performance, and patient outcomes is needed to effectively tackle these issues. Ultimately,
we must update the standards that must be met by all surgical trainees prior to graduation. There are,
however, several knowledge gaps that must be addressed before the full potential of this approach can be
realized. The purpose of this proposal is to close those gaps and map a policy response moving forward. The
specific research aims of this proposal are to (i) determine the operative performance of early career surgeons
assessed using risk-adjusted outcomes in national Medicare claims data; (ii) determine if a surgeon’s trainee
performance ratings are valid predictors of their early career risk-adjusted patient outcomes; and (iii) determine
if initial certification of surgeons immediately after training reliably discriminate early career surgeon
performance. This study will, for the first time, determine the degree to which early career surgeon competence
impacts health care quality and whether existing measures of trainee competence are useful predictors of early
career performance. The results of this study can ultimately be used to implement new training standards to
ensure that all early career surgeons are competent. These changes are urgently needed to safeguard the
health of millions of American patients. This project will also facilitate the career development of the candidate.
The highly experienced and multidisciplinary mentorship team, the proposed career development and research
plan, and the unparalleled research environment are ideally suited to address the career goals and educational
needs of the candidate PI, Brian George, MD, MA. Although he has substantial prior experience assessing
surgical trainee performance, he has no experience using Medicare claims data to assess risk-adjusted
outcomes. These skills are necessary for him to achieve his goal of ensuring that all early career surgeons
provide safe care. This proposal therefore includes additional training which will be essential both for the
successful completion of this research and for Dr. George’s career development, including graduate level
courses in Medicare claims data analysis, the use of risk-adjusted outcomes for performance measurement,
and advanced statistical modeling. This career development award will lay the groundwork for Dr. George to
mature as an independent investigator and national leader in understanding how to ensure all surgeons
provide safe care when they enter practice.

## Key facts

- **NIH application ID:** 10210486
- **Project number:** 1K08HS027653-01A1
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Brian George
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $148,111
- **Award type:** 1
- **Project period:** 2021-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10210486

## Citation

> US National Institutes of Health, RePORTER application 10210486, Early career surgeon performance - a patient safety blind spot (1K08HS027653-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10210486. Licensed CC0.

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