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The Accreditation Council of Graduate Medical Education (ACGME) case minimums led to fewer shoulder and knee arthroscopies for orthopaedic surgery residents. This decrease may stem from underreporting of surgical cases.

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Area of Science:

  • Orthopaedic Surgery Training
  • Surgical Education Research

Background:

  • The Accreditation Council of Graduate Medical Education (ACGME) established case minimums for surgical residency programs.
  • These minimums aim to ensure residents gain adequate operative experience before graduation.

Purpose of the Study:

  • To evaluate the impact of the 2013 ACGME case minimum implementation on arthroscopic shoulder and knee procedures performed by orthopaedic surgery residents.
  • To analyze trends in resident case logs before and after the policy change.

Main Methods:

  • Utilized ACGME orthopaedic surgery case log data from 2007 to 2019.
  • Compared mean and median arthroscopic shoulder and knee case numbers per resident pre- (2007-2012) and post-implementation (2013-2019).

Main Results:

  • A significant decrease was observed in the mean number of shoulder arthroscopies (109.8 vs. 82.0, P=.025) and knee arthroscopies (178.6 vs. 124.8, P=.006) after 2013.
  • Overall mean total cases also decreased significantly (2045.5 vs. 1699.3, P=.038).
  • Residents at the tenth percentile still met ACGME minimums annually.

Conclusions:

  • Implementation of ACGME case minimums correlated with a significant reduction in shoulder and knee arthroscopies performed by residents.
  • Underreporting of surgical cases may contribute to the observed decrease.
  • The findings highlight potential shifts in resident operative experience following ACGME policy changes.