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Surgical caseload in army general surgery programs: a 10-year retrospective
Rebecca Marier McGuigan1, Alan L Beitler
1Department of Surgery, Madigan Army Medical Center, Tacoma, Washington, USA.
Current Surgery
|August 12, 2005
Summary
Army surgical residents train in programs with fewer cases than national averages, yet consistently achieve higher board exam pass rates. This indicates high-quality surgical education despite declining caseloads in military medicine.
Area of Science:
- Surgical Education
- Military Medicine
- Graduate Medical Training
Background:
- The Army Medical Department (AMEDD) experienced a military-wide drawdown, impacting patient volume and acuity.
- This led to questions about the quantity and quality of surgical training within Army programs.
Purpose of the Study:
- To compare Army general surgery residency caseloads with national averages.
- To compare the board examination performance of Army residents with national pass rates.
Main Methods:
- Data on resident caseloads and examination performance from 1990-2000 were collected from 4 of 6 Army programs.
- Caseloads and board pass rates were compared with national data from the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Surgery (ABS).
Main Results:
- Army residents had lower average total and chief resident caseloads than the national average.
- Chief resident case numbers trended downward in Army programs.
- Despite fewer cases, Army graduates had higher pass rates on qualifying and certifying examinations than the national average.
- Procedure volumes in endoscopy, thoracic, and breast surgery exceeded national averages.
Conclusions:
- Army surgical residents perform fewer cases than civilian counterparts.
- Declining chief resident case numbers reflect changes in military medicine.
- Army residency graduates demonstrate superior performance on American Board of Surgery examinations.