Variability in Surgical Case Volume of Orthopaedic Surgery Residents: 2007 to 2013

Abstract

Introduction: Variability in orthopaedic surgery training is an important issue facing trainees. We examined orthopaedic surgery case logs for subspecialty case volume during residency training and assessed trends and variability in case volume over time. We hypothesized that there is variability in training in all subspecialties encountered in orthopaedic surgery resident training and that the volume of cases in each subspecialty has increased over time.

Methods: Annual surgical case logs of the Accreditation Council for Graduate Medical Education from 2007 to 2013 for orthopaedic surgery residency were assessed for variability and case volume trends.

Results: The average total adult cases logged per graduating resident in 2007 was 1,952, which increased to 2,291 in 2013, representing a 17.4% increase (P = 0.00041). The gap in case volume between residents in the 10th and 90th percentiles for case exposure decreased from 2007 to 2013 (P = 0.0268), although the 10th percentile group still logged significantly fewer procedures compared with the 90th percentile group in 2013 (P = 0.0159).

Conclusions: Although case volume is not the sole determinant of surgical skill and further study is needed to investigate the effects of training experience, this variability in surgical volume may affect the knowledge, skill, and practice patterns of surgeons.