A new study published in the Journal of the American Academy of Orthopaedic Surgeons examines variability in surgical case volume for orthopedic surgery residents.
The researchers examined annual surgical case logs of the Accreditation Council for Graduate Medical Education from 2007 to 2013. They hypothesized there is variability in training for all subspecialties in orthopedic surgery resident training and volume in each subspecialty has increased over time.
The researchers found:
1. The average total adult cases logged per graduating resident increased 17.4 percent from 2007 to 2013. The residents logged 1,952 cases in 2007 and jumped to 2,291 in 2013.
2. There was a gap in case volume between residents at the 10th percentile and 90th percentile. The gap for case exposure decreased over the study period, but the 10th percentile still logged significantly fewer procedures than the 90th percentile.
3. The difference between the 10th percentile and 90th percentile was particularly stark for these subspecialties:
• Humerous/elbow
• Forearm/wrist
• Pelvis/hip
• Femur/knee
• Spine
• Total adult
• Total pediatric
4. Resident case load isn't the only determinant of quality; instructors also gauge quality by mentorship, didactics, case breadth and complexity, individual learning ability and style. The competency-based training could become increasingly important in surgeon training in the future and many surgeons are undergoing fellowships after resident training.
5. The researchers concluded, "Although case volume is not the sole determinant of surgical skill and further study is needed to investigate the effects of training experience, the variability in surgical volume may affect the knowledge, skill and practice pattern of surgeons."