Narrowing of the surgical resident operative experience: A 27-year analysis of national ACGME case logs

Surgery ◽  
2018 ◽  
Vol 164 (3) ◽  
pp. 577-582 ◽  
Author(s):  
Alexander R. Cortez ◽  
Gianna D. Katsaros ◽  
Vikrom K. Dhar ◽  
F. Thurston Drake ◽  
Timothy A. Pritts ◽  
...  
Keyword(s):  
Surgical Resident ◽  
Operative Experience ◽  
Case Logs

Resident operative experience in pediatric neurosurgery across the United States

2021 ◽  
pp. 1-9
Author(s):  
Rahul Kumar ◽  
David S Hersh ◽  
Luke G. F Smith ◽  
William E Gordon ◽  
Nickalus R Khan ◽  
...  
Keyword(s):  
Diversity Index ◽  
Pediatric Neurosurgery ◽  
The United States ◽  
Case Volume ◽  
Pediatric Case ◽  
Accreditation Council ◽  
Site Characteristics ◽  
Recent Graduates ◽  
Operative Experience ◽  
Case Logs

OBJECTIVE Neurosurgical residents receive exposure to the subspecialty of pediatric neurosurgery during training. The authors sought to determine resident operative experience in pediatric neurosurgery across Accreditation Council for Graduate Medical Education (ACGME)–accredited neurosurgical programs. METHODS During 2018–2019, pediatric neurosurgical case logs for recent graduates or current residents who completed their primary pediatric exposure were collected from US continental ACGME training programs. Using individual resident reports and procedure designations, operative volumes and case diversity were analyzed collectively, according to training site characteristics, and also correlated with the recently described Resident Experience Score (RES). RESULTS Of the 114 programs, a total of 316 resident case logs (range 1–19 residents per program) were received from 86 (75%) programs. The median cumulative pediatric case volume per resident was 109 (IQR 75–161). Residents at programs with a pediatric fellowship reported a higher median case volume (143, IQR 96–187) than residents at programs without (91, IQR 66–129; p < 0.0001). Residents at programs that outsource their pediatric rotation had a lower median case volume (84, IQR 52–114) compared with those at programs with an in-house experience (117, IQR 79–170; p < 0.0001). The case diversity index among all programs ranged from 0.61 to 0.80, with no statistically significant differences according to the Accreditation Council for Pediatric Neurosurgery Fellowships designation or pediatric experience site (p > 0.05). The RES correlated moderately (r = 0.44) with median operative volumes per program. A program’s annual pediatric operative volume and duration of pediatric experience were identified as significant predictive factors for median resident operative volume. CONCLUSIONS Resident experience in pediatric neurosurgery is variable within and between programs. Case volumes are generally higher for residents at programs with in-house exposure and an accredited fellowship, but case diversity is relatively uniform across all programs. RES provides some insight on anticipated case volume, but other unexplained factors remain.

Attending Surgeon Variation in Operative Case Length: An Opportunity for Quality Improvement

2018 ◽  
Vol 84 (10) ◽  
pp. 1595-1599
Author(s):  
Kirollos S. Malek ◽  
Jukes P. Namm ◽  
Carlos A. Garberoglio ◽  
Maheswari Senthil ◽  
Naveen Solomon ◽  
...  
Keyword(s):  
Operative Time ◽  
Resident Training ◽  
Careful Consideration ◽  
Analysis Of Covariance ◽  
Surgical Resident ◽  
Or Efficiency ◽  
American Society ◽  
Case Logs ◽  
American Society Of Anesthesiologists ◽  
The Impact

Balancing resident education with operating room (OR) efficiency, while accommodating different styles of surgical educators and learners, is a challenging task. We sought to evaluate variability in operative time for breast surgery cases. Accreditation Council for Graduate Medical Education case logs of breast operations from 2011 to 2017 for current surgical residents at Loma Linda University were correlated with patient records. The main outcome measure was operative time. Breast cases were assessed as these operations are performed during all postgraduate years (PGY). Breast procedures were grouped according to similarity. Variables analyzed included attending surgeon, PGY level, procedure type, month of operation, and American Society of Anesthesiologists class. Of 606 breast cases reviewed, median overall operative time was 150 minutes (interquartile range 187–927). One-way analysis of covariance demonstrated statistically significant variation in operative time by attending surgeon controlling for covariates (PGY level, procedure, American Society of Anesthesiologists class, and month) ( P = 0.04). With institutional OR costs of $30 per minute, the average difference between slowest and fastest surgeon was $2400 per case [(218–138) minutes 3 $30/min]. Minimizing variability for common procedures performed by surgical educators may enhance OR efficiency. However, the impact of case length on surgical resident training requires careful consideration.

scholarly journals Analysis of Neurosurgery Resident Operative Experience: Training Tomorrow's Neurosurgeon

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Shahjehan Ahmad ◽  
Bledi C Brahimaj
Keyword(s):  
United States ◽  
Medical Education ◽  
Statistical Significance ◽  
The United States ◽  
Case Volume ◽  
The Past ◽  
Operative Experience ◽  
Case Logs ◽  
Adult Spine ◽  
Neurological Surgery

Abstract INTRODUCTION The Accreditation Council for Graduate Medical Education (ACGME) maintains self-reported logs of cases completed by US residents. This study analyzes trends in the operative experience of neurosurgical residents within the context of national case trends in neurosurgery over the past decade. METHODS ACGME case logs from 2013 to 2018 were reviewed. Operative domains were categorized as adult cranial, adult spinal, pediatrics, and epilepsy. Mean operative volume was recorded, as well as cases performed as senior or lead surgeon. As a measure of US national operative trends, the PearlDiver database was queried for operative volume between 2007 and 2016. Statistical analysis was performed using linear regression, and statistical significance was set at P < .05. RESULTS During the study period, the total case volume for neurological surgery residents increased by 61 cases every residency year (P < .001). Cases logged as lead surgeon increased by 173 cases every year, while cases logged as senior surgeon decreased by 112 cases every year (P < .05). The operative volume for adult spine and cranial increased (P < .05), while that for extracranial vascular and pediatric decreased (P < .05). Brain tumor, transsphenoidal, radiosurgery, shunting, and epilepsy volume remained stable over the study period (P > .05). These resident operative trends paralleled trends nationwide where there were increases in adult cranial, adult spine, and epilepsy (P < .001) but decreases in pediatric cases (P < .05). CONCLUSION Over the past decade, neurosurgical residents have been completing an increasing number of cases every year in the majority of operative domains. While an increased experience is beneficial, what is more important is that the resident operative experience appears to closely mirror trends for commonly performed operations in the United States. This is reassuring for surgical educators that tomorrow's neurosurgeons will have the competency to meet our nation's neurosurgical needs.

scholarly journals Disparities in hepatopancreatobiliary operative experience among general surgery residents: a 27-year analysis of ACGME case logs

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S35
Author(s):  
R.C. Quillin ◽  
A.R. Cortez ◽  
D.N. Debow ◽  
G.D. Katsaros ◽  
F.T. Drake ◽  
...  
Keyword(s):  
General Surgery ◽  
Operative Experience ◽  
Case Logs

scholarly journals Impacts on Surgery Resident Education at a First Wave COVID-19 Epicenter

2020 ◽  
Vol 7 ◽  
pp. 238212052097502
Author(s):  
Alexander Ostapenko ◽  
Samantha McPeck ◽  
Shawn Liechty ◽  
Daniel Kleiner
Keyword(s):  
Resident Training ◽  
Surgical Resident ◽  
Training And Education ◽  
Surgical Residents ◽  
High Effect ◽  
Negative Effect ◽  
Case Logs ◽  
Surgery Resident ◽  
Junior Residents ◽  
Development Objective

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.

Recent trends in the operative experience of junior pediatric surgical attendings: a study of APSA applicant case logs

2015 ◽  
Vol 50 (1) ◽  
pp. 186-190 ◽  
Author(s):  
Christopher A. Behr ◽  
Anthony J. Hesketh ◽  
Meredith Akerman ◽  
Stephen E. Dolgin ◽  
Robert A. Cowles
Keyword(s):  
Recent Trends ◽  
Operative Experience ◽  
Case Logs

scholarly journals Trends in Ophthalmology Resident Operative Experience and the Early Impact of the COVID-19 Pandemic

2021 ◽  
Vol 13 (02) ◽  
pp. e200-e209
Author(s):  
Andreas K. Lauer ◽  
Sophia M. Chung ◽  
Daniel C. Tu ◽  
Jeffrey R. SooHoo ◽  
John R. Potts
Keyword(s):  
Cataract Surgery ◽  
Early Period ◽  
Glaucoma Surgery ◽  
The Novel ◽  
Minimum Number ◽  
The Mean ◽  
Operative Experience ◽  
Case Logs ◽  
Novel Coronavirus ◽  
The Impact

Abstract Purpose This study aimed to evaluate trends in ophthalmology resident operative experience and the early impact of the novel coronavirus disease 2019 (COVID-19) pandemic. Design Present study is a retrospective analysis of the Accreditation Council for Graduate Medical Education (ACGME) Case Log System. Participants Anonymized graduating resident case logs from 2011 to 2020 academic years (AYs) were examined for this study. Methods Regression analysis for each procedure category was performed to identify trends between 2011 and 2019 AYs. Unpaired two-tailed t-test compared 2018 to 2019 and 2019 to 2020 AY's for each category surgeon (S) and as surgeon and assistant (S + A). Main Outcome Measures Mean and median cases as (S) and (S + A) during 2011 to 2019 AYs. Comparison between 2018 to 2019 and 2019 to 2020 AY's for each category as (S) and (S + A) to evaluate the impact of the COVID-19 pandemic. Results Total ophthalmology procedures as (S) rose from a mean of 479.6 to 601.3 (p < 0.001; R 2 = 0.96; Δ/year = 16.9) and a median of 444 to 537 (p < 0.001; R 2 = 0.97; Δ/year = 13.1). Total procedures as (S + A) rose from a mean of 698.1 to 768 (p < 0.01; R 2 = 0.83; Δ/year = 9.07) and a median of 677 to 734 (p < 0.05; R 2 = 0.61; Δ/year = 6.64). Cataract procedures as (S) rose from a mean of 152.8 to 208 (p < 0.001; R 2 = 0.99; Δ/year = 7.98) and a median of 146 to 197 (p < 0.001; R 2 = 0.97; Δ/year = 7.87). Cataract procedures as both (S + A) rose from a mean 231.4 to 268.7 (p < 0.001; R 2 = 0.95; Δ/year = 5.5) and a median of 213 to 254 (p < 0.001; R 2 = 0.93; Δ/year = 5.33). Between 2018 to 2019 and 2019 to 2020 AYs, the first pandemic year was associated with significant reductions in total procedures (601.3–533.7 [p < 0.0001]) as (S) and 768.0 to 694.4 (p < 0.0001) as (S + A), cataract surgery (208–162.2 [p < 0.0001]) as (S) and 268.7 to 219.1 (p < 0.0001) as (S + A), and glaucoma surgery (16.3–14.2 [p = 0.0068]) as (S) and 25.6 to 22.6 (p = 0.0063) as (S + A). Conclusion During 2011 to 2019 AYs, cataract, intravitreal injections, glaucoma, and total procedures increased significantly. During the early period of the COVID-19 pandemic (2019–2020 AY), national halting of elective procedures had a precipitous effect on resident cataract surgery experience to volumes similar to 2013 to 2014 AY where the mean was twice the current required minimum number. With few exceptions, other procedure volumes remained stable.

scholarly journals Impacts on Surgery Resident Education at a first wave COVID-19 epicenter

2020 ◽  
Author(s):  
Alexander Ostapenko ◽  
Samantha McPeck ◽  
Shawn Liechty ◽  
Daniel Kleiner
Keyword(s):  
Resident Training ◽  
Surgical Resident ◽  
Training And Education ◽  
Surgical Residents ◽  
High Effect ◽  
Negative Effect ◽  
Case Logs ◽  
Surgery Resident ◽  
Junior Residents ◽  
Development Objective

Background: 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.

scholarly journals Impacts on Surgery Resident Education at a first wave COVID-19 Epicenter

2020 ◽  
Author(s):  
Alexander Ostapenko ◽  
Samantha McPeck ◽  
Shawn Liechty ◽  
Daniel Kleiner
Keyword(s):  
Resident Training ◽  
Surgical Resident ◽  
Training And Education ◽  
Surgical Residents ◽  
High Effect ◽  
Negative Effect ◽  
Case Logs ◽  
Surgery Resident ◽  
Junior Residents ◽  
Development Objective

Abstract Background: 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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