PubMed · 4859647
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J Moldaver, L Mayers. 1974-01-07. Letter: Plugging the drain.. https://doi.org/10.1001/jama.227.1.80b
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OBJECTIVE: To evaluate the effect of staff mobility on student teaching, the training of young surgeons, and the volume of research in an academic department of surgery of a tropical teaching hospital. DESIGN: Retrospective study of academic staffing in the department of surgery of the Ahmadu Bello University Teaching Hospital between 1975 and 1993. SETTING: Zaria, Nigeria. SUBJECTS: 42 academic staff, 1190 medical students, and 110 registrars (trainee surgeons). MAIN OUTCOME MEASURES: Number of academic staff in post, medical students, and registrars; number of research papers in latter years of the study. RESULTS: In 19 years, 42 academic staff worked for varying periods (1-15 years) in the university department of surgery in Zaria. These included six professors, 12 senior lecturers, and 24 lecturers. Although staff numbers diminished, numbers of students and registrars increased year by year. Average number of publications dropped from a peak of 14.4 to 7.4 a year. CONCLUSION: Staffing of the department has fallen steadily over the years and has adversely affected the department's primary responsibility of teaching students and training young surgeons.
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The authors studied the knowledge base of surgical faculty concerning frozen section consultations at a university hospital to determine whether it had any relationship to the appropriateness of frozen section requests. To accomplish this, the reasons for performing frozen sections during a 3-month period were analyzed, and those request that seemed ambiguous or inappropriate were identified. Simultaneously a 15-item questionnaire was distributed to faculty and housestaff dealing with factual information concerning the technique and limitations of frozen section diagnosis (Questions 1-8), as well as appropriateness of frozen section requests in a number of clinical situations (Questions 9-15). The collective score on items of general information (Questions 1-8) was 69%, whereas scores on Questions 9-15 ranged from 39% on the gynecologic question related to evaluation of a cystic ovarian mass to 81% on the general surgery question regarding evaluation of a soft tissue mass. Of 914 frozen sections, 95% were performed for appropriate reasons, which included evaluation of margins (46%), establishing a primary diagnosis (43%), determining adequacy or viability of tissue (3%), or satisfying immediate patient/family concerns ( < 1%). Five percent of frozen sections were performed for ambiguous or seemingly inappropriate reasons. Because fewer than five faculty members were responsible for the inappropriate frozen section request, the authors did not find that the results of the questionnaire predicted or anticipated situations in which inappropriate requests occurred. Nonetheless, the results of the questionnaire indicate there is important general information concerning frozen sections that is not uniformly shared by surgical faculty, such as the types of tissue that cannot be cut on a cryostat, the reasons for deferred frozen sections, and the situations in which fresh tissue is needed for special studies. The authors suggest the inappropriate frozen section could be diminished by an educational initiative targeted at a relatively small segment of clinical faculty, whereas enhancement of general information regarding frozen section should ideally occur in the broader context of clinical conferences using illustrative case material.