National Trends in Orthopaedic Surgery Resident Adult Case Logs

Purpose: This study aims to identify the effects of the COVID-19 pandemic on surgical resident training and education at Danbury Hospital. Methods: We conducted an observational study at a Western Connecticut hospital heavily affected by the first wave of the COVID-19 pandemic to assess its effects on surgical residents, focusing on surgical education, clinical experience, and operative skills development. Objective data was available through recorded work hours, case logs, and formal didactics. In addition, we created an anonymous survey to assess resident perception of their residency experience during the pandemic. Results: There are 22 surgical residents at our institution; all were included in the study. Resident weekly duty hours decreased by 23.9 hours with the majority of clinical time redirected to caring for COVID-19 patients. Independent studying increased by 1.6 hours (26.2%) while weekly didactics decreased by 2.1 hours (35.6%). The operative volume per resident decreased by 65.7% from 35.0 to 12.0 cases for the period of interest, with a disproportionately high effect on junior residents, who experienced a 76.2% decrease. Unsurprisingly, 70% of residents reported a negative effect of the pandemic on their surgical skills. Conclusions: During the first wave of the COVID-19 pandemic, surgical residents’ usual workflows changed dramatically, as much of their time was dedicated to the critical care of patients with COVID-19. However, the consequent opportunity cost was to surgery-specific training; there was a significant decrease in operative cases and time spent in surgical didactics, along with elevated concern about overall preparedness for their intended career.

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Arthroscopy Volume in United States Residency Programs: Are New Trainees Prepared?

The Journal of Hip Surgery ◽

10.1055/s-0039-1694766 ◽

2019 ◽

Vol 03 (03) ◽

pp. 124-129

Author(s):

Christopher N. Carender ◽

Alan G. Shamrock ◽

Kyle R. Duchman ◽

Natalie A. Glass ◽

T. Sean Lynch ◽

...

Keyword(s):

United States ◽

Hip Arthroscopy ◽

Orthopaedic Surgery ◽

Knee Arthroscopy ◽

The United States ◽

Median Number ◽

Published Data ◽

Diagnostic Arthroscopy ◽

Case Logs ◽

Arthroscopic Procedures

AbstractArthroscopy is a technically demanding procedure with a prolonged learning curve. The purpose of this study is to determine if current arthroscopic case volume over the course of an orthopaedic surgery residency is sufficient to meet the number of cases required to achieve competence and/or mastery in complex arthroscopic tasks as well as hip arthroscopy. Publicly available Accreditation Council for Graduate Medical Education case log data for arthroscopic procedures from accredited orthopaedic residencies were reviewed from 2007 to 2017. Linear and segmental regression analyses were used to identify temporal trends, with significance set to p < 0.05. From 2007 to 2013, there was a significant increase in the median number of shoulder and knee arthroscopy case logs (p < 0.001). A sharp decline in the median number of shoulder and knee arthroscopy case logs was seen in 2013 to 2014 (p < 0.001), and the number remained low from 2014 to 2017 (p = 0.02, p = 0.03). The median number of hip arthroscopy procedures logged increased significantly from zero cases in 2012 (range: 0–48 cases) to five cases in 2017 (range: 0–76 cases) (p = 0.02). Over the study period, the median number of total arthroscopic procedures decreased from 301 to 186 (p = 0.01). In the United States, the majority of orthopaedic surgery residents graduate with case log numbers that meet theoretical minimum requirements for competence in basic diagnostic arthroscopy of the shoulder, hip, and knee. Resident experience with hip arthroscopy has increased; however, the majority of residents are graduating with little to no hip arthroscopy experience. Moreover, the median number of total arthroscopic procedures has declined to the point where the average graduate may not be able to perform complex hip or shoulder arthroscopy tasks based on previously published data. These findings support the need for further investigation into the best methods for training residents interested in performing arthroscopy as part of their careers. This was a level of evidence III, retrospective cohort study.

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Social Media and Its Use in Orthopaedic Surgery Resident Education and Training

JBJS Reviews ◽

10.2106/jbjs.rvw.21.00083 ◽

2021 ◽

Vol 9 (11) ◽

Author(s):

Wendell W. Cole ◽

Andre Perez-Chaumont ◽

Cadence Miskimin ◽

Mary K. Mulcahey

Keyword(s):

Social Media ◽

Orthopaedic Surgery ◽

Resident Education ◽

Education And Training ◽

Surgery Resident ◽

And Training

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An AOA Critical Issue Should There Be a Minimal Surgical Experience for a Graduating Orthopaedic Surgery Resident?*

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.e.01062 ◽

2006 ◽

Vol 88 (5) ◽

pp. 1153-1159 ◽

Cited By ~ 2

Author(s):

Michael A. Simon ◽

Dempsey S. Springfield ◽

Steven P. Nestler

Keyword(s):

Orthopaedic Surgery ◽

Critical Issue ◽

Surgical Experience ◽

Surgery Resident

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Resident Exposure to Peripheral Nerve Surgical Procedures During Residency Training

Journal of Graduate Medical Education ◽

10.4300/jgme-d-15-00318.1 ◽

2016 ◽

Vol 8 (2) ◽

pp. 173-179 ◽

Cited By ~ 7

Author(s):

Joseph A Gil ◽

Alan H Daniels ◽

Edward Akelman

Keyword(s):

Peripheral Nerve ◽

Plastic Surgery ◽

Surgical Procedures ◽

General Surgery ◽

Orthopaedic Surgery ◽

Case Volume ◽

Peripheral Nerve Surgery ◽

Case Logs ◽

Nerve Surgery ◽

Neurological Surgery

ABSTRACT Variability in case exposures has been identified for orthopaedic surgery residents. It is not known if this variability exists for peripheral nerve procedures.Background The objective of this study was to assess ACGME case log data for graduating orthopaedic surgery, plastic surgery, general surgery, and neurological surgery residents for peripheral nerve surgical procedures and to evaluate intraspecialty and interspecialty variability in case volume.Objective Surgical case logs from 2009 to 2014 for the 4 specialties were compared for peripheral nerve surgery experience. Peripheral nerve case volume between specialties was performed utilizing a paired t test, 95% confidence intervals were calculated, and linear regression was calculated to assess the trends.Methods The average number of peripheral nerve procedures performed per graduating resident was 54.2 for orthopaedic surgery residents, 62.8 for independent plastic surgery residents, 84.6 for integrated plastic surgery residents, 22.4 for neurological surgery residents, and 0.4 for surgery residents. Intraspecialty comparison of the 10th and 90th percentile peripheral nerve case volume in 2012 revealed remarkable variability in training. There was a 3.9-fold difference within orthopaedic surgery, a 5.0-fold difference within independent plastic surgery residents, an 8.8-fold difference for residents from integrated plastic surgery programs, and a 7.0-fold difference within the neurological surgery group.Results There is interspecialty and intraspecialty variability in peripheral nerve surgery volume for orthopaedic, plastic, neurological, and general surgery residents. Caseload is not the sole determinant of training quality as mentorship, didactics, case breadth, and complexity play an important role in training.Conclusions

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Variability in Foot and Ankle Case Volume in Orthopaedic Residency Training

Foot & Ankle Specialist ◽

10.1177/1938640016687371 ◽

2017 ◽

Vol 10 (6) ◽

pp. 531-537 ◽

Cited By ~ 7

Author(s):

Steven F. DeFroda ◽

Joseph A. Gil ◽

Brad D. Blankenhorn ◽

Alan H. Daniels

Keyword(s):

Orthopaedic Surgery ◽

Rapid Development ◽

Foot And Ankle ◽

Case Volume ◽

New Techniques ◽

Surgical Residency ◽

Surgical Case ◽

Orthopaedic Residency ◽

Case Logs ◽

Ankle And Foot

Surgical case volume during orthopaedic surgical residency is a concern among trainees and program directors alike. With an ongoing trend toward further subspecialization and the rapid development of new techniques and devices, the breadth of procedures that residents are exposed to continues to increase. Accreditation Council for Graduate Medical Education surgical case logs from 2009 to 2013 for graduating orthopaedic surgery residents were examined to assess the national averages of orthopaedic procedures logged by graduating orthopaedic surgery residents in the leg/ankle and foot/toes categories. This investigation revealed that there was an 8% increase in the total number of leg/ankle cases and 12% increase in foot/toes cases performed by graduating orthopaedic surgery residents, which has not significantly increased from 2009 to 2013. Across years examined in this study, significant variability existed between the 10th and 90th percentiles for total foot and ankle resident case exposure (P < .05), particularly within ankle arthroscopy, where there was a 15-fold difference in the number of arthroscopy cases performed by residents in the 90th percentile compared with the 10th percentile. The overall volume of foot and ankle cases performed by graduating orthopaedic surgery residents has increased despite not being statistically significantly from 2009 to 2013. Levels of Evidence: Level III: Cohort study

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The Value of Mentorship in Orthopaedic Surgery Resident Education: The Residentsʼ Perspective

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.h.00934 ◽

2009 ◽

Vol 91 (4) ◽

pp. 1017-1022 ◽

Cited By ~ 70

Author(s):

John H Flint ◽

A Alex Jahangir ◽

Bruce D Browner ◽

Samir Mehta

Keyword(s):

Orthopaedic Surgery ◽

Resident Education ◽

Surgery Resident

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