An Interval Look at the Transplant Surgery Pipeline: Insights from General Surgery Residents' Operative Experience...

Area of Science:

• Surgical Education
• Transplant Surgery Outcomes
• Healthcare Workforce Trends

Background:

• Declining interest in transplant surgery fellowships among US graduates is a growing concern.
• Regulatory changes impacting transplant rotations for surgical residents may influence trainee experience.
• Understanding resident operative volume in transplant surgery is crucial for addressing workforce shortages.

Purpose of the Study:

• To examine trends in transplant surgery operative volume among US general surgery residents over a 20-year period.
• To assess the impact of regulatory changes on resident exposure to transplant procedures.
• To determine if changes in operative volume correlate with declining interest in transplant surgery fellowships.

Main Methods:

• Retrospective analysis of Accreditation Council for Graduate Medical Education (ACGME) operative logs from 1999-2021.
• Categorization of data into two periods: 1999-2010 (Period 1) and 2011-2021 (Period 2), relative to regulatory changes.
• Analysis of resident involvement in renal and liver transplantations nationally.

Main Results:

• The proportion of transplant cases to total major cases remained stable at approximately 1% throughout the study period.
• Average number of transplant cases per resident showed a statistically insignificant increase from 10.0 in Period 1 to 10.8 in Period 2.
• Renal transplants constituted over 50% of resident transplant operative experience, with national involvement proportions remaining consistent.

Conclusions:

• Resident operative volume in transplant surgery has been largely consistent over the past two decades.
• The stability in surgical case volume suggests it is not a primary driver of decreased trainee interest in transplant surgery.
• Further research is needed to identify factors contributing to the declining number of US graduates pursuing transplant surgery.