Postgraduate medical education homogenizes surveillance strategies after primary therapy for rectal carcinoma patients

Introduction: Continuing medical education (CME) is believed to be valuable, but evidence of this is scanty. We investigated how surgeon age affects surveillance strategies utilized by surgeons following their own patients with rectal carcinoma. We reasoned that, if there were no significant differences in strategies among surgeons of various ages, the homogenization would be attributable to CME. Methods: We surveyed the 1,795 members of the American Society of Colon and Rectal Surgeons (ASCRS) using a questionnaire based on 4 succinct vignettes describing idealized patients treated with curative intent for TNM stages I-III rectal carcinoma. The surgeons were asked how often they use 14 specific surveillance modalities during years 1-5 after surgery. The motivation underlying their surveillance practices was analyzed using a menu of 12 possible factors and a Likert scale of 1 (lowest effect on motivation) to 10 (highest effect). We assessed the effect of surgeon age on follow-up intensity using repeated-measures ANOVA. One-way ANOVA was used to analyze the effect of surgeon age on motivation. Results: Of the 566 responses, 347 were considered evaluable. There were no significant differences among age strata (30-39, 40-49, 50-59, and ≥ 60) in surveillance practices for any of the 4 vignettes. Only one motivating factor differed significantly among age strata: psychosocial support for the patient; surgeons ≥ 60 were motivated more strongly (Likert score 6.9; p < .05) by this factor than younger surgeons (Likert score 5.8). Conclusions: CME helps homogenize this important aspect of clinical cancer management among ASCRS surgeons.