Operative Experience During Orthopaedic Residency Compared with Early Practice in the U.S

Area of Science:

• Orthopaedic Surgery
• Surgical Education
• Medical Training

Background:

• Surgical education aims to prepare residents for independent practice.
• The alignment of residency training with actual practice is not fully understood.
• This study evaluates procedure frequency in residency versus early practice.

Purpose of the Study:

• To identify the most frequent orthopaedic surgical procedures during residency.
• To identify the most frequent orthopaedic surgical procedures in early surgical practice.
• To compare procedure frequency between residency and early practice.

Main Methods:

• Retrospective cohort study analyzing American Medical Association (AMA) Current Procedural Terminology (CPT) codes.
• Included U.S. orthopaedic surgery residents (2010-2012) and surgeons certified by the American Board of Orthopaedic Surgery (2013-2015).
• Determined relative rates for adult and pediatric surgeries with frequencies of ≥0.1%.

Main Results:

• Knee and shoulder arthroscopy were most common in adults for both groups.
• Humerus/elbow fractures and "other musculoskeletal" procedures were most common in pediatric cases.
• Discrepancies noted: 4 adult and 6 pediatric codes were significantly more frequent in residency; 8 adult and 7 pediatric codes were less frequent.

Conclusions:

• Residency training generally aligns well with early surgical practice.
• Identified specific CPT codes with substantial differences in frequency between residency and practice.
• Findings can guide residencies to optimize trainee exposure to commonly performed procedures.