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General Surgery Trainee Cases Over Time: Postgraduate Year Matters.

Ana Sofia Ore¹, Betty S Liu¹, Hao W Chen¹

¹Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.

The American Surgeon

|December 24, 2022

Summary

General surgery resident operative experience remained stable over a decade, with shifts in case distribution and increased minimally invasive procedures. Trainee case volume and breadth were largely preserved despite changes in postgraduate year case assignments.

Keywords:

fellow graduate medical education operative volume resident surgical education

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Area of Science:

Surgical Education
Graduate Medical Education
Operative Experience Analysis

Background:

Concerns exist regarding surgical trainee operative volume, competency, and readiness for independent practice.
Surgical graduate medical education emphasizes the importance of adequate operative experience for trainees.
Analyzing changes in general surgery trainee operative experience is crucial for curriculum development.

Purpose of the Study:

To analyze the evolution of general surgery trainee operative experience over time.
To compare operative case distribution by postgraduate year between 2009 and 2018.
To assess changes in case complexity and surgical approach over a decade.

Main Methods:

Review of institutional operative records from 2009 and 2018 at a main hospital site.
Inclusion of cases involving general, vascular, or thoracic surgery trainees.
Comparison of case numbers per trainee level, trainee combinations, and case categories over time.

Main Results:

Total cases remained similar (1940 in 2009 vs. 1967 in 2018).
Significant shifts in case distribution by postgraduate year (PGY), with increases in PGY-3/4 and decreases in PGY-2/5.
Increased double-scrubbed cases (19.6% to 26.8%), rise in robotic/endovascular procedures, and decline in open cases.

Conclusions:

Resident operative volume has been largely preserved over a decade.
Changes observed include altered case distribution by trainee level and increased multi-trainee involvement.
A notable trend towards minimally invasive surgery (robotic, endovascular) with a decrease in open procedures.