Training our future endocrine surgeons: a look at the endocrine surgery operative experience of U.S. surgical residents

Abstract

Background: During the last 10 years, the number of endocrine procedures performed in the United States has increased significantly. We sought to determine whether this has translated into an increase in operative volume for general surgery and otolaryngology residents.

Methods: We evaluated records from the Resident Statistic Summaries of the Residency Review Committee (RRC) for U.S. general surgery and otolaryngology residents for the years 2004-2008, specifically examining data on thyroidectomies and parathyroidectomies.

Results: Between 2004 and 2008, the average endocrine case volume of U.S. general surgery and otolaryngology residents increased by approximately 15%, but otolaryngology residents performed more than twice as many operations as U.S. general surgery residents. The growth in case volume was mostly from increases in the number of thyroidectomies performed by U.S. general surgery and otolaryngology residents (17.9 to 21.8, P = .007 and 46.5 to 54.4, P = .04). Overall, otolaryngology residents also performed more parathyroidectomies than their general surgery counterparts (11.6 vs 8.8, P = .007).

Conclusion: Although there has been an increase in the number of endocrine cases performed by graduating U.S. general surgery residents, this is significantly smaller than that of otolaryngology residents. To remain competitive, general surgery residents wishing to practice endocrine surgery may need to pursue additional fellowship training.

Figure 1

As surgeon juniors (SJ), otolaryngology residents on average performed 14.8 thyroidectomies compared to 11.6 performed by general surgery residents (p=0.02). Otolaryngology chief residents (OTO SC) also, on average, performed more thyroidectomies than general surgery surgeon chiefs (GS SC), (34.8 vs. 8.3, p<0.001).

Figure 2

As junior level residents, general surgeons performed more parathyroidectomies than their otolaryngology colleagues (5.1 vs. 3.6, p=0.001). Otolaryngology chief residents participate in more parathyroid procedures then general surgery chiefs (8.0 vs. 3.7, p=0.002).

Figure 3

In each year examined, at least one otolaryngology resident performed a larger number of maximum thyroid cases when compared to their general surgery counterparts. When divided by resident level of training both at a surgeon junior and chief level, otolaryngology residents perform a higher maximum number of thyroid cases.

Figure 4

Otolaryngology residents outperform general surgery residents in the maximum number of parathyroid procedures performed by a single resident in a given year. This trend was also demonstrated when cases were divided by resident level of training with otolaryngology chief resident and surgeon junior residents performing a greater number of maximum cases then their general surgery counterparts.