Impact of 2013 ACGME Minimum Case Requirements on Orthopedic Resident Operative Volume

Abstract

In 2013, the Accreditation Council for Graduate Medical Education (ACGME) mandated orthopedic surgery residents to perform at least 1000 surgical cases during residency and specified "case minimums" for 15 core procedure categories. We assessed trends in the volume and variability of graduating orthopedic surgery resident caseload since the implementation of these case minimums. We performed a retrospective linear regression analysis of ACGME-published case log data of US orthopedic residents graduating from 2014 to 2019, with trend analysis, comparison of case volume between residents in 10th and 90th percentiles, and comparison of logged cases vs case minimums for core procedures. Median total procedures performed increased from 1464 (range, 592-2842) in 2014 to 1709 (range, 870-3318) in 2019, representing a 17% increase in case volume (P<.001). Residents performing at the 90th percentile logged twice as many cases as residents performing at the 10th percentile. Of the core procedures, carpal tunnel release and total knee arthroplasty most greatly exceeded ACGME requirements (performed at 4.3 to 4.7 times the minimums, respectively). Graduating resident case volume increased significantly from 2014 to 2019. Variability in operative experience remains high and did not change significantly during the study period. [Orthopedics. 2022;45(1):25-30.].