<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1816-8949</journal-id>
<journal-title><![CDATA[Anales de la Facultad de Ciencias Médicas (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[An. Fac. Cienc. Méd. (Asunción)]]></abbrev-journal-title>
<issn>1816-8949</issn>
<publisher>
<publisher-name><![CDATA[EFACIM. Editorial de la Facultad de Ciencias Médicas - Universidad Nacional de Asunción]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1816-89492026000100111</article-id>
<article-id pub-id-type="doi">10.18004/anales/2026.e59012611</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Percepción de los cirujanos sobre su formación para el ejercicio autónomo de la especialidad]]></article-title>
<article-title xml:lang="en"><![CDATA[Perception of surgeons regarding their training for autonomous practice of the specialty]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Segovia Lohse]]></surname>
<given-names><![CDATA[Helmut Alfredo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aldana Ubillus]]></surname>
<given-names><![CDATA[Celso Augusto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gamarra Sosa]]></surname>
<given-names><![CDATA[José Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez Cantore]]></surname>
<given-names><![CDATA[José Aníbal]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Hospital de Clínicas]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<volume>59</volume>
<numero>1</numero>
<fpage>111</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1816-89492026000100111&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1816-89492026000100111&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1816-89492026000100111&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: Durante la residencia de cirugía general el médico residente amplía sus conocimientos, habilidades y aptitudes, adquiriendo progresivamente autonomía. En las últimas décadas los cambios en los modelos de enseñanza-aprendizaje han generado interrogantes sobre la preparación real del egresado.  Objetivo: Explorar la percepción de los actores clave del proceso educativo sobre la formación de los médicos residentes de cirugía general del Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Paraguay, para el ejercicio profesional autónomo.  Métodos: Investigación cualitativa de enfoque hermenéutico interpretativo, realizada mediante 15 entrevistas semiestructuradas -cinco residentes, cinco cirujanos recién egresados y cinco tutores- entre noviembre y diciembre de 2020. El análisis fue de contenido temático, organizado en torno a dos dimensiones y nueve descriptores.  Resultados: Los residentes de cirugía general egresan sin estar preparados para el ejercicio autónomo, aunque son capaces de realizar cirugías de baja complejidad. La mayoría desea subespecializarse. Los participantes demandan mayor número de cirugías, uso sistemático de simuladores y rotaciones estructuradas. La pandemia COVID-19 agravó deficiencias preexistentes. Los tutores fueron identificados como principal fortaleza institucional.  Conclusiones: La preparación para el ejercicio autónomo es incompleta. Prolongar la residencia sin resolver los problemas de infraestructura y gestión administrativa no mejorará la formación.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  During general surgery residency, the resident physician expands their knowledge, skills, and competencies, progressively acquiring autonomy. In recent decades, changes in teaching-learning models have raised questions regarding the actual preparedness of graduates.  Objective:  To explore the perception of key stakeholders in the educational process regarding the training of general surgery residents at the Hospital de Clínicas, Faculty of Medical Sciences, Universidad Nacional de Asunción, Paraguay, for autonomous professional practice.  Methods:  Qualitative research with an interpretative hermeneutic approach, conducted through 15 semi-structured interviews&#8212;five residents, five recently graduated surgeons, and five tutors&#8212;between November and December 2020. The analysis was thematic content analysis, organized around two dimensions and nine descriptors.  Results:  General surgery residents graduate without being adequately prepared for autonomous practice, although they are capable of performing low-complexity surgeries. Most participants expressed a desire to pursue subspecialization. Participants reported the need for a higher number of surgical procedures, systematic use of simulators, and structured rotations. The COVID-19 pandemic exacerbated pre-existing deficiencies. Tutors were identified as the main institutional strength.  Conclusions:  Preparation for autonomous practice is incomplete. Extending the duration of residency without addressing infrastructure and administrative management issues will not improve training.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[residencia médica]]></kwd>
<kwd lng="es"><![CDATA[cirugía general]]></kwd>
<kwd lng="es"><![CDATA[percepción]]></kwd>
<kwd lng="es"><![CDATA[autonomía profesional]]></kwd>
<kwd lng="es"><![CDATA[educación médica]]></kwd>
<kwd lng="es"><![CDATA[investigación cualitativa.]]></kwd>
<kwd lng="en"><![CDATA[medical residency]]></kwd>
<kwd lng="en"><![CDATA[general surgery]]></kwd>
<kwd lng="en"><![CDATA[perception]]></kwd>
<kwd lng="en"><![CDATA[professional autonomy]]></kwd>
<kwd lng="en"><![CDATA[medical education]]></kwd>
<kwd lng="en"><![CDATA[qualitative research.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<collab>Facultad de Ciencias Médicas UNA</collab>
<source><![CDATA[Acta N. 3085 Resolución N. 0647-00-2018. Por la cual se aprueba la modificación del reglamento y normas de las residencias médicas de la FCM-UNA]]></source>
<year>2018</year>
<publisher-loc><![CDATA[San Lorenzo ]]></publisher-loc>
<publisher-name><![CDATA[FCM-UNA]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Miní]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Medina]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Peralta]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Rojas]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Butron]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gutiérrez]]></surname>
<given-names><![CDATA[EL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Programa de Residentado Médico: Percepciones de los Médicos Residentes en hospitales de Lima y Callao]]></article-title>
<source><![CDATA[Rev Perú Med Exp Salud Pública]]></source>
<year>2015</year>
<volume>32</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>303-10</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<collab>Facultad de Ciencias Médicas UNA</collab>
<source><![CDATA[Curso de Especialización en Cirugía General. Dirección de Postgrado]]></source>
<year>2011</year>
<publisher-loc><![CDATA[Asunción ]]></publisher-loc>
<publisher-name><![CDATA[FCM-UNA]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<collab>CONAREM</collab>
<source><![CDATA[Oferta de plazas de las residencias médicas de especialidades troncales y primarias - 2020]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Asunción ]]></publisher-loc>
<publisher-name><![CDATA[Instituto Nacional de Salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Napolitano]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Savarise]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Paramo]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Soot]]></surname>
<given-names><![CDATA[LC]]></given-names>
</name>
<name>
<surname><![CDATA[Todd]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Gregory]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Are general surgery residents ready to practice? A survey of the American College of Surgeons Board of Governors and Young Fellows Association]]></article-title>
<source><![CDATA[J Am Coll Surg]]></source>
<year>2014</year>
<volume>218</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1063-72</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vazquez Reta]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Vazquez Guerrero]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[¿Cómo educar al residente de cirugía?]]></article-title>
<source><![CDATA[Cir Gen]]></source>
<year>2007</year>
<volume>29</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>95-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mattar]]></surname>
<given-names><![CDATA[SG]]></given-names>
</name>
<name>
<surname><![CDATA[Alseidi]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[DB]]></given-names>
</name>
<name>
<surname><![CDATA[Jeyarajah]]></surname>
<given-names><![CDATA[DR]]></given-names>
</name>
<name>
<surname><![CDATA[Swanstrom]]></surname>
<given-names><![CDATA[LL]]></given-names>
</name>
<name>
<surname><![CDATA[Aye]]></surname>
<given-names><![CDATA[RW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>2013</year>
<volume>258</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>440-9</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Coleman]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Esposito]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
<name>
<surname><![CDATA[Rozycki]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
<name>
<surname><![CDATA[Feliciano]]></surname>
<given-names><![CDATA[DV.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Early subspecialization and perceived competence in surgical training: are residents ready?]]></article-title>
<source><![CDATA[J Am Coll Surg]]></source>
<year>2013</year>
<volume>216</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>764-71</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ortiz]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Molinas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Espínola de Canata]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Percepción de Médicos Residentes sobre la Calidad de sus Programas de Formación.]]></article-title>
<source><![CDATA[Rev Salud Pública Parag]]></source>
<year>2014</year>
<volume>4</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>16-25</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[George]]></surname>
<given-names><![CDATA[BC]]></given-names>
</name>
<name>
<surname><![CDATA[Bohnen]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[Meyerson]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Schuller]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Clark]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Readiness of US General Surgery Residents for Independent Practice]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>2017</year>
<volume>266</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>582-94</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gadamer]]></surname>
<given-names><![CDATA[HG]]></given-names>
</name>
</person-group>
<source><![CDATA[Verdad y método]]></source>
<year>2005</year>
<edition>11.ª ed</edition>
<publisher-loc><![CDATA[Salamanca ]]></publisher-loc>
<publisher-name><![CDATA[Sígueme]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Patton]]></surname>
<given-names><![CDATA[MQ.]]></given-names>
</name>
</person-group>
<source><![CDATA[Qualitative research &amp; evaluation methods]]></source>
<year>2015</year>
<edition>4th ed</edition>
<publisher-loc><![CDATA[Thousand Oaks ]]></publisher-loc>
<publisher-name><![CDATA[Sage]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Creswell]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
</person-group>
<source><![CDATA[Qualitative inquiry and research design: choosing among five traditions]]></source>
<year>2013</year>
<edition>3rd ed</edition>
<publisher-loc><![CDATA[Thousand Oaks ]]></publisher-loc>
<publisher-name><![CDATA[Sage]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bardin]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Análisis de contenido]]></source>
<year>2002</year>
<edition>2.ª ed</edition>
<publisher-loc><![CDATA[Madrid ]]></publisher-loc>
<publisher-name><![CDATA[Akal]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lincoln]]></surname>
<given-names><![CDATA[Y.S.]]></given-names>
</name>
<name>
<surname><![CDATA[Guba]]></surname>
<given-names><![CDATA[E.G]]></given-names>
</name>
</person-group>
<source><![CDATA[Naturalistic inquiry]]></source>
<year>1985</year>
<page-range>289-331</page-range><publisher-loc><![CDATA[Newbury Park (CA) ]]></publisher-loc>
<publisher-name><![CDATA[Sage Publications]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="book">
<collab>ANEAES</collab>
<source><![CDATA[Criterios de Calidad para la evaluación y acreditación de la Especialidad Médica en Cirugía General]]></source>
<year>2020</year>
<publisher-loc><![CDATA[Asunción ]]></publisher-loc>
<publisher-name><![CDATA[ANEAES]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yaow]]></surname>
<given-names><![CDATA[CYL]]></given-names>
</name>
<name>
<surname><![CDATA[Mok]]></surname>
<given-names><![CDATA[HT]]></given-names>
</name>
<name>
<surname><![CDATA[Ng]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Devi]]></surname>
<given-names><![CDATA[MK]]></given-names>
</name>
<name>
<surname><![CDATA[Iyer]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Chong]]></surname>
<given-names><![CDATA[CS.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Difficulties faced by general surgery residents: a qualitative systematic review]]></article-title>
<source><![CDATA[J Surg Educ]]></source>
<year>2020</year>
<volume>77</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1396-406</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bell Jr]]></surname>
<given-names><![CDATA[RH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Why Johnny cannot operate]]></article-title>
<source><![CDATA[Surgery]]></source>
<year>2009</year>
<volume>146</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>533-42</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fronza]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Prystowsky]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[DaRosa]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Fryer]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgical residents&#8217; perception of competence and relevance of the clinical curriculum to future practice]]></article-title>
<source><![CDATA[J Surg Educ]]></source>
<year>2012</year>
<volume>69</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>792-7</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Debas]]></surname>
<given-names><![CDATA[HT]]></given-names>
</name>
<name>
<surname><![CDATA[Bass]]></surname>
<given-names><![CDATA[BL]]></given-names>
</name>
<name>
<surname><![CDATA[Brennan]]></surname>
<given-names><![CDATA[MF]]></given-names>
</name>
<name>
<surname><![CDATA[Flynn]]></surname>
<given-names><![CDATA[TC]]></given-names>
</name>
<name>
<surname><![CDATA[Folse]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Freischlag]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[American Surgical Association Blue Ribbon Committee Report on Surgical Education: 2004]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>2005</year>
<volume>241</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-8</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dousset]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La formation des chirurgiens digestifs et viscéraux: une évolution nécessaire]]></article-title>
<source><![CDATA[Ann Chir]]></source>
<year>2004</year>
<volume>129</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>395-8</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Whang]]></surname>
<given-names><![CDATA[EE]]></given-names>
</name>
<name>
<surname><![CDATA[Mello]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Ashley]]></surname>
<given-names><![CDATA[SW]]></given-names>
</name>
<name>
<surname><![CDATA[Zinner]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Implementing resident work hour limitations: lessons from the New York State experience.]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>2003</year>
<volume>237</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>449-55</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
