Variability in Resident Operative Hand Experience by Specialty.

Area of Science:

• Surgical training and education
• Orthopedic surgery
• General surgery

Background:

• Standardization of hand surgery training in the US is a growing concern.
• Variability in operative hand experience among surgical residents requires analysis.

Purpose of the Study:

• To analyze and compare the variability in operative hand experience between orthopedic and general surgery residents.
• To identify potential gaps and opportunities in current hand surgery training models.

Main Methods:

• Utilized American Council of Graduate Medical Education case logs from 2006-2015 for orthopedic and general surgery residents.
• Compared hand surgery case volumes between specialties using parametric tests.
• Assessed intraspecialty variation in orthopedic surgery for various hand procedure categories.

Main Results:

• Analyzed case logs for 9,605 general surgery and 5,911 orthopedic surgery residents.
• Orthopedic surgery residents performed significantly more hand surgery cases than general surgery residents (P < .001).
• General surgery residents had minimal hand experience, with no reported cases in soft tissue repairs, vascular repairs, or replants; significant intraspecialty variation was observed in orthopedic surgery.

Conclusions:

• General surgeons may be an underutilized resource to address the demand for hand surgeon specialists.
• Further research is necessary to establish acceptable training variability levels in hand surgery.