Practice Readiness? Trends in Chief Resident Year Training Experience Across 13 Residency Programs

Area of Science:

• Medical Education
• Surgical Training
• Urology

Background:

• Urology residency aims to equip trainees for independent practice.
• The ideal operative experience during the chief resident year remains undefined.

Purpose of the Study:

• To analyze the temporal trends of surgical case volume completed by urology residents during residency and their chief year.
• To assess the impact of these trends on preparedness for independent practice.

Main Methods:

• Data from Accreditation Council for Graduate Medical Education case logs of urology residents from 2010-2022 were aggregated.
• Five index procedure categories were analyzed: general urology, endourology, reconstructive urology, urologic oncology, and pediatric urology.
• Trends in case completion during the chief year relative to overall residency training were examined.

Main Results:

• A total of 1,287,433 cases were logged by 479 residents, with 29% performed during the chief year.
• Urologic oncology cases constituted the highest proportion (56%) of chief resident cases.
• Significant downward trends were observed in the median percentage of general urology (-0.68, P=.013) and endourology (-1.71, P≤.001) cases completed during the chief year.

Conclusions:

• Chief residents are increasingly focused on urologic oncology procedures, exceeding 50% of their cases.
• Declining exposure to general urology and endourology during the chief year may affect residents' readiness for independent practice.