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—five residents, five recently graduated surgeons, and five tutors—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.

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