Differences in early career operative experiences among pediatric urologists

Area of Science:

• Urology
• Surgical Education
• Pediatric Surgery

Background:

• Pediatric urology fellowships aim to prepare surgeons for early career cases.
• Concerns exist regarding the actual complexity and diversity of cases new pediatric urologists perform.
• Understanding practice patterns is crucial for surgical training and workforce planning.

Purpose of the Study:

• To determine the frequency of procedures performed by newly trained pediatric urologists.
• To identify factors influencing case complexity and diversity.
• To assess differences in surgical case volume and complexity between male and female surgeons.

Main Methods:

• Review of case logs from pediatric urologists applying for certification between 2007 and 2013.
• Analysis of 51 index cases per urologist, assessing procedure complexity and diversity (CPT codes).
• Comparison of case volumes and complexity based on surgeon demographics (sex) and practice volume quartiles.

Main Results:

• Surgeons in the highest case volume quartile performed significantly more cases across all complexity levels compared to the lowest quartile.
• Common procedures included circumcisions, orchiopexies, and inguinal hernia repairs; rare procedures included open nephroureterectomies and complete male epispadias repair.
• Male surgeons performed more cases overall, particularly those of minimal and significant complexity, compared to female surgeons.

Conclusions:

• Significant variability exists in case diversity and complexity among newly trained pediatric urologists.
• The majority of new pediatric urologists perform a high volume of minor procedures.
• Disparities in operative experience, particularly between male and female surgeons, underscore the importance of ongoing education and mentorship.