EP402 - Colorectal Surgery Outcomes from a Chief Resident-Run Service: A Model for Graduated Autonomy in Surgical Training

Sunday, May 10, 2026

12:46 PM - 12:51 PM ET

ePoster Presenter(s)

Amanda Stella-Adams, DO (she/her/hers)

General Surgery Resident
Jefferson-Abington Hospital
Jefferson-Abington Hospital
Philadelphia, PA, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

SF

Steven Fassler, MD, FACS FASCRS (he/him/his)

Chief, Colon and Rectal Surgery Abington-Jefferson Health
Abington Jefferson Health
Sidney Kimmel Medical College, Thomas Jefferson University
Abington, PA, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

JO

Jesse C. Ottaway, MD

Surgical Resident
Jefferson Abington Hospital
Thomas Jefferson University
Philadelphia, PA, United States

Disclosure information not submitted.
mz

mark zebley, md

surgeon
colon and rectal associates
abington, Pennsylvania, United States

Disclosure information not submitted.
SK

Soo Kim, MD FASCRS

attending surgeon
Jefferson Abington
Abington, Pennsylvania, United States

Disclosure information not submitted.
DM

David McKeown, MD MCh, MRCS, FASCRS

Associate Professor of Surgery
Thomas Jefferson University Hospital
Jenkintown, Pennsylvania, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Amanda Stella-Adams, DO: This individual has no financial relationships with ineligible companies.

Steven Fassler, MD, FACS FASCRS: This individual has no financial relationships with ineligible companies.

David McKeown, MD MCh, MRCS, FASCRS: This individual has no financial relationships with ineligible companies.

Purpose/Background: Graduated autonomy in surgical residency has been eroded by regulatory, institutional, and cultural changes, often leaving trainees underprepared for independent practice. Chief resident-run services have been proposed as a means to provide meaningful autonomy under appropriate supervision. We evaluated colorectal surgical outcomes from a chief resident-run service to determine whether this model can safely promote independence while maintaining quality of care.

Methods/Interventions: We performed a retrospective review of patients undergoing colorectal procedures through a chief resident-run clinic and surgical service at a community teaching hospital from 2021 to 2024. Chief residents performed outpatient evaluations, coordinated perioperative care, and served as primary operating surgeons under direct supervision. Demographics, operative details, and outcomes were abstracted from the electronic medical record. Primary outcomes included operative duration, length of stay, and 30-day complications (surgical site infection, readmission, reoperation, or mortality). Results were compared with national NSQIP benchmarks for matched colorectal procedures.

Results/Outcomes: A total of 109 colorectal surgeries were conducted predominantly by chief residents, comprising colorectal resections, stoma-related procedures, anorectal cases, and colonoscopies. The outcomes, including median operative duration, length of hospital stay, and 30-day complications such as wound infections, readmissions, and reoperations, were comparable to national NSQIP benchmarks for similar procedures. There were no 30-day mortalities.

Conclusion/Discussion: Colorectal procedures performed within a chief resident-run service were safe and yielded outcomes comparable to national benchmarks. This model provides comprehensive autonomy across outpatient, inpatient, and operative domains without compromising patient care. Chief resident-run services represent a valuable framework for enhancing surgical education and preparing trainees for independent colorectal practice.