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Review
. 2021 Sep 7;6(3):e21.00023.
doi: 10.2106/JBJS.OA.21.00023. eCollection 2021 Jul-Sep.

A Review of Orthopaedic Resident Case Logs to Identify Fluctuations in Exposure to Adult Orthopaedic Procedures

Michael F Levidy  1 , Andrew Dobitsch  1 , Justin Luis  1 , Adam N Fano  1 , Ashok Para  1 , Michael Vosbikian  1   2 , Kathleen Beebe  1   2 , Neil Kaushal  1   2
Affiliations
Review

A Review of Orthopaedic Resident Case Logs to Identify Fluctuations in Exposure to Adult Orthopaedic Procedures

Michael F Levidy et al. JB JS Open Access. .

Abstract

Introduction: Orthopaedic surgery resident case exposure is an important component of surgical training and is monitored by the Accreditation Council for Graduate Medical Education (ACGME) to ensure resident readiness for graduation. The purpose of this study was to investigate trends in exposure to adult orthopaedic surgical procedures and analyze the impact of the 2013 update in ACGME case logging expectations.

Methods: A retrospective review of ACGME case log data was conducted for adult orthopaedic procedures performed by graduating orthopaedic surgery residents from 2012 to 2020. Trends in the number of cases logged and the case share by anatomical location were investigated. Linear regression analysis was performed to analyze changes in case number over the 9-year period.

Results: For all surgical categories, there was stability in the average case number per resident from 2012 to 2013, followed by a precipitous decrease from 2013 to 2014. From 2014 to 2020, there has been a gradual increase in case number for all categories except "other musculoskeletal (MSK)," resulting in a total 46% recovery since the 2014 decline. Concomitant with the decline, there was a relative increase in pelvis/hip and femur/knee procedures and decrease in shoulder, other MSK, and spine procedures. From 2014 to 2020, shoulder, humerus/elbow, pelvis/hip, leg/ankle, foot/toes, and spine cases have gradually accounted for a larger proportion of total cases while femur/knee and "other MSK" cases have accounted for less.

Conclusions: The 2013 update in ACGME case logging expectations was associated with a significant decrease in case number. This is likely a reflection of residents correctly entering 1 primary Current Procedural Terminology code for each surgical case. Programs should be aware of a general increase in case number since 2014 and acknowledge the fact that some procedure types may be given priority from a logging standpoint when multiple Current Procedural Terminology codes apply.

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Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A307).

Figures

Fig. 1
Fig. 1
Average total number of cases logged from 2012 to 2020.
Fig. 2
Fig. 2
Average number of cases from 2012 to 2022 stratified by anatomical location.
See this image and copyright information in PMC

References

    1. ACGME, Accreditation Council for Graduate Medical Education. Review Committee for Orthopaedic Surgery. Chicago, IL: Case Log Guidelines Review Committee for Orthopaedic Surgery; 2013.
    1. DiSegna S, Kelley T, DeMarco D, Patel A. Effects of accreditation Council for graduate medical education duty hour regulations on clinical preparedness of first-year orthopaedic attendings: a survey of senior orthopaedic surgeons. J Surg Orthop Adv. 2018;27(1):42-6. - PubMed
    1. Stotts AK, Kohring JM, Presson AP, Millar MM, Harrast JJ, Van Heest AE, Zhang C, Saltzman CL. Perceptions of the recommended resident experience with common orthopaedic procedures. J Bone Joint Surg. 2019;101(13):e63. - PMC - PubMed
    1. Gil JA, Daniels AH, Weiss AP. Variability in surgical case volume of orthopaedic surgery residents: 2007 to 2013. J Am Acad Orthop Surg. 2016;24(3):207-12. - PubMed
    1. Pierce TP, Ermann D, Scillia AJ, Festa A, Emami A, McInerney VK. National trends in orthopaedic surgery resident adult case logs. J Surg Educ. 2019;76(3):893-7. - PubMed