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BACKGROUND: Residency programs, especially in surgery, have been undergoing constant changes. The profile of residents in surgical fields is changing too since residents are now part of the Generation Y (Millenials). This change in profile mandates a re-evaluation to adapt surgical residency programs. Six years ago, we carried out a study evaluating attitudes and experiences during training, and the professional expectations of residents. This study aims to survey surgical residents to evaluate current attitudes, experiences, and expectations. METHODS: We surveyed 50 residents to determine professional satisfaction, residency-program satisfaction, future expectations, financial expectations, and correct attitude towards patients. RESULTS: Our results show that half of the residents are satisfied with the residency program. However, dissatisfaction reaches 40% on surgical volume and 80% on mentorship; 62% of the residents are not confident to perform operations after the residency, the majority believes a specialization is necessary; most residents believe financial compensation will decrease with time, but concerns with reimbursement are low; and most residents are worried about injuring patients, but only two thirds are satisfied working with patients. CONCLUSIONS: Current residents present lower job satisfaction and more criticism of teaching techniques. These changes compared to previous results match the profile of Generation Y, who is more iconoclastic when compared to previous generations.

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SUMMARY BACKGROUND: Residency programs, especially in surgery, have been undergoing constant changes. The profile of residents in surgical fields is changing too since residents are now part of the Generation Y (Millenials). This change in profile mandates a re-evaluation to adapt surgical residency programs. Six years ago, we carried out a study evaluating attitudes and experiences during training, and the professional expectations of residents. This study aims to survey surgical residents to evaluate current attitudes, experiences, and expectations. METHODS: We surveyed 50 residents to determine professional satisfaction, residency-program satisfaction, future expectations, financial expectations, and correct attitude towards patients. RESULTS: Our results show that half of the residents are satisfied with the residency program. However, dissatisfaction reaches 40% on surgical volume and 80% on mentorship; 62% of the residents are not confident to perform operations after the residency, the majority believes a specialization is necessary; most residents believe financial compensation will decrease with time, but concerns with reimbursement are low; and most residents are worried about injuring patients, but only two thirds are satisfied working with patients. CONCLUSIONS: Current residents present lower job satisfaction and more criticism of teaching techniques. These changes compared to previous results match the profile of Generation Y, who is more iconoclastic when compared to previous generations.

RESUMO INTRODUÇÃO: Os programas de residência, especialmente em cirurgia, estão em constante mudança. O perfil dos residentes nos campos cirúrgicos também vem mudando, dado que atuais residentes fazem parte da Geração Y (Millennials). Essa mudança de perfil demanda uma reavaliação para adaptar os programas de residência. Este estudo tem como objetivo entrevistar os residentes de áreas cirúrgicas para avaliar suas atuais atitudes, experiência e expectativas. MÉTODOS: Entrevistamos 50 residentes para determinar satisfação profissional, expectativas em relação ao futuro, expectativas financeiras e atitude correta em relação aos pacientes. RESULTADOS: A insatisfação com o volume cirúrgico chega a 40% e a 80% com a preceptoria; 62% dos residentes não se sentem confiantes para realizar procedimentos sozinhos após o fim do programa e a maioria acredita que uma especialização cirúrgica é necessária; a maioria dos residentes acredita que os ganhos monetários diminuirão com o tempo. CONCLUSÃO: Os atuais residentes apresentam menor satisfação com o trabalho quando comparados com os antigos, e são mais críticos quanto ao ambiente de ensino. Essas mudanças seguem as premissas da Geração Y, cujos participantes são mais iconoclastas quando comparados a gerações passadas.

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INTRODUCTION:: High resolution manometry is the current technology used to the study of esophageal motility and is replacing conventional manometry in important centers for esophageal motility with parameters used on esophageal motility, following the Chicago Classification. This classification unifies high resolution manometry interpretation and classifies esophageal disorders. OBJECTIVE:: This review shows, in a pictorial presentation, the new parameters established by the Chicago Classification, version 3.0, aimed to allow an easy comprehension and interpretation of high resolution manometry. METHODS:: Esophageal manometries performed by the authors were reviewed to select illustrative tracings representing Chicago Classification parameters. RESULTS:: The parameters are: Esophagogastric Morphology, that classifies this junction according to its physiology and anatomy; Integrated Relaxation Pressure, that measures the lower esophageal sphincter relaxation; Distal Contractile Integral, that evaluates the contraction vigor of each wave; and, Distal Latency, that measures the peristalsis velocity from the beginning of the swallow to the epiphrenic ampulla. CONCLUSION:: Clinical applications of these new concepts is still under evaluation. OBJETIVO:: Mostrar, de forma pictórica, os novos parâmetros compilados na versão 3.0 da Classificação de Chicago, buscando facilitar a compreensão e interpretação da manometria de alta resolução. MÉTODOS:: Foram revistas as manometrias da casuística dos autores e selecionados os traçados representativos dos parâmetros da Classificação de Chicago. RESULTADOS:: Entre os parâmetros apresentados foram considerados a Morfologia da Transição Gastroesofágica, que classifica o segmento de acordo com sua fisiologia e anatomia; a Integral da Pressão de Relaxamento, que mede o relaxamento do esfíncter esofagiano inferior; a Integral Contrátil Distal, que avalia o vigor contrátil da onda peristáltica; e, a Latência Distal, que mede o tempo da peristalse, desde o início da deglutição até a ampola epifrênica. CONCLUSÃO:: A aplicabilidade clínica desses novos conceitos ainda está sendo estudada.

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ABSTRACT Introduction: High resolution manometry is the current technology used to the study of esophageal motility and is replacing conventional manometry in important centers for esophageal motility with parameters used on esophageal motility, following the Chicago Classification. This classification unifies high resolution manometry interpretation and classifies esophageal disorders. Objective: This review shows, in a pictorial presentation, the new parameters established by the Chicago Classification, version 3.0, aimed to allow an easy comprehension and interpretation of high resolution manometry. Methods: Esophageal manometries performed by the authors were reviewed to select illustrative tracings representing Chicago Classification parameters. Results: The parameters are: Esophagogastric Morphology, that classifies this junction according to its physiology and anatomy; Integrated Relaxation Pressure, that measures the lower esophageal sphincter relaxation; Distal Contractile Integral, that evaluates the contraction vigor of each wave; and, Distal Latency, that measures the peristalsis velocity from the beginning of the swallow to the epiphrenic ampulla. Conclusion: Clinical applications of these new concepts is still under evaluation.

RESUMO A manometria de alta resolução é, atualmente, a tecnologia mais moderna para o estudo da motilidade esofágica e vem substituindo a manometria convencional nos grandes centros de pesquisa com parâmetros que seguem a Classificação de Chicago, que busca unificar as interpretações gráficas da manometria de alta resolução e, dessa maneira, categorizar os diversos distúrbios esofágicos. Objetivo: Mostrar, de forma pictórica, os novos parâmetros compilados na versão 3.0 da Classificação de Chicago, buscando facilitar a compreensão e interpretação da manometria de alta resolução. Métodos: Foram revistas as manometrias da casuística dos autores e selecionados os traçados representativos dos parâmetros da Classificação de Chicago. Resultados: Entre os parâmetros apresentados foram considerados a Morfologia da Transição Gastroesofágica, que classifica o segmento de acordo com sua fisiologia e anatomia; a Integral da Pressão de Relaxamento, que mede o relaxamento do esfíncter esofagiano inferior; a Integral Contrátil Distal, que avalia o vigor contrátil da onda peristáltica; e, a Latência Distal, que mede o tempo da peristalse, desde o início da deglutição até a ampola epifrênica. Conclusão: A aplicabilidade clínica desses novos conceitos ainda está sendo estudada.

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