Variations in procedure time based on surgery resident postgraduate year level.

Area of Science:

• Surgical Education
• Healthcare Economics
• Operating Room Efficiency

Background:

• Increasing focus on healthcare resource allocation necessitates data on operating room (OR) training costs.
• Limited data exists regarding the impact of resident surgical training on procedure times and associated costs.

Purpose of the Study:

• To evaluate the association between surgical resident postgraduate year (PGY) and operative time for laparoscopic cholecystectomies (LCs) and pancreaticoduodenectomies (PDs).
• To determine the cost implications of resident involvement in surgical procedures.

Main Methods:

• Retrospective analysis of 357 LCs and 236 PDs performed between July 2006 and July 2011.
• Exclusion criteria applied to ensure procedural consistency and single-resident involvement (except interns).
• Multiple linear regression used to assess the relationship between PGY and procedure time, controlling for patient age and estimated blood loss.

Main Results:

• For LCs, a marginally significant inverse relationship was found between PGY and procedure time (P=0.0519), with each PGY increase reducing OR time by 2.66 minutes.
• The estimated cost savings for LCs performed by a PGY-5 versus a PGY-1 resident was $192.90 per case.
• No significant association between PGY and procedure time was observed for PDs.

Conclusions:

• Junior residents (lower PGY) may extend operative times for simpler procedures like LCs.
• Resident PGY does not significantly impact operative times for more complex procedures such as PDs.
• Findings have implications for surgical training program efficiency and healthcare cost management.