COVID-19 Did Not Stop the Rising Tide: Trends in Case Volume Logged by Surgical Residents

Abstract

Introduction

The coronavirus pandemic has profoundly impacted all facets of surgical care, including surgical residency training. The objective of this study was to assess the operative experience and overall case volume of surgery residents before and during the pandemic.

Methods

Using data from the Accreditation Council for Graduate Medical Education (ACGME) annual operative log reports, operative volume for 2015-2021 graduates of ACGME-accredited general, orthopedic, neuro- and plastic surgery residency programs was analyzed using non-parametric Kendall-tau correlation analysis. The period before the pandemic was defined as AY14-15 to AY18-19, and the pandemic period was defined as AY19-20 to AY20-21.

Results

Operative data for 8,556 general, 5,113 orthopedic, 736 plastic, and 1,278 neurosurgery residency graduates were included. Between 2015-2021, total case volume increased significantly for general surgery graduates (Kendall's tau-b: 0.905, p=0.007), orthopedic surgery graduates (Kendall's tau-b: 1.000, p=0.003), neurosurgery graduates (Kendall's tau-b: 0.905, p=0.007), and plastic surgery graduates (Kendall's tau-b: 0.810, p=0.016). Across all specialties, the mean total number of cases performed by residents graduating during the pandemic was higher than among residents graduating before the pandemic, though no formal significance testing was performed. Among general surgery residents, the number of cases performed as surgeon chief among residents graduating in AY19-20 decreased for the first time in 5 years, though the overall volume remained higher than the prior year, and returned to pre-pandemic trends in AY20-21.

Conclusion

Over the past 7 years, the case volume of surgical residents steadily increased. Surgical trainees who graduated during the coronavirus pandemic have equal or greater total operative experience compared to trainees who graduated prior to the pandemic.