Size Matters? The Relationship Between Residency Program Size and Operative Experience in Plastic Surgery-A 9-year...

Area of Science:

• Medical Education
• Surgical Training
• Plastic Surgery

Background:

• Residency program size is regulated by the Accreditation Council for Graduate Medical Education (ACGME).
• Operative case volume is a key metric in plastic surgery training.
• The impact of program size on resident case volumes is not well understood.

Purpose of the Study:

• To evaluate the relationship between plastic surgery residency program size and resident operative case volumes.
• To determine if program size affects the number or type of cases logged by residents.

Main Methods:

• Retrospective cohort study utilizing ACGME case logs.
• Included all graduating plastic surgery residents from US-accredited programs (2014-2023).
• Compared case volumes between large (≥3 residents) and small (<3 residents) programs.

Main Results:

• 1902 graduates were analyzed; total case volumes were similar between large and small programs (2387 vs. 2241).
• Residents in large programs logged significantly more breast cases (570 vs. 491).
• No significant differences were found in aesthetic, craniofacial/head and neck, or hand/nerve case volumes.

Conclusions:

• Plastic surgery residents in programs of varying sizes achieve comparable overall operative case volumes.
• Operative exposure remains stable over time, regardless of program size.
• Findings support the robustness of plastic surgery training across different residency program sizes.