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Trends of core versus subspecialty operative procedures completed in general surgery residency training programs
  1. Faiz Tuma1,
  2. Rafael D Malgor2,
  3. Nikit Kapila3,
  4. Mohamed K Kamel3
  1. 1 Central Michigan University College of Medicine, Saginaw, Michigan, USA
  2. 2 University of Colorado Denver Anschutz Medical Center Bookstore, Aurora, Colorado, USA
  3. 3 General Surgery, Central Michigan University College of Medicine East Campus, Saginaw, Michigan, USA
  1. Correspondence to Dr Faiz Tuma, Central Michigan University College of Medicine, Department of Surgery, Saginaw, Michigan, USA; faiz.tuma{at}


Introduction General surgery residency involves performing subspecialty procedures in addition to the core general procedures. However, the proportion of core general surgery versus subspecialty procedures during training is variable and its temporal changes are unknown. The goal of our study was to assess the current trends in core general surgery and subspecialty procedure distributions during general surgery residency training.

Methods Data were collected from the ACGME core general surgery national resident available report case logs from 2007 to 2019. Descriptive and time series analyses were used to compare proportions of average procedures performed per resident in the core general surgery category versus the subspecialty category. F-tests were conducted to show whether the slopes of the trend lines were significantly non-zero.

Results The mean of total procedures completed for major credit by the average general surgery resident increased from 910.1 (SD=30.31) in 2007 to 1070.5 (SD=37.59) in 2019. Over that same period, the number of general, cardiothoracic, plastic and urology surgery procedures increased by 24.9%, 9.8%, 76.6% and 19.3%, respectively. Conversely, vascular and paediatric surgery procedures decreased by 7.6% and 30.7%, respectively. The neurological surgery procedures remain stable at 1.1 procedures per resident per year. A significant positive correlation in the trend reflecting total (p<0.0001), general (p<0.0001) and plastic (p<0.0016) surgery procedures and the negative correlation in the trend lines for vascular (p<0.0006) and paediatric (p<0.0001) surgery procedures were also noted.

Conclusions Trends in overall surgical case volume performed by general surgery residents over the last 12 years have shown a steady increase in operative training opportunity despite the increasing number of subspecialty training programmes and fellowships. Further research to identify areas for improvement and to study the diversity of operative procedures, and their outcomes is warranted in the years to come.

  • surgery
  • education & training (see medical education & training)

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Presented at Presented at the 16th Annual Academic Surgical Congress, February 2021.

  • Contributors FT contributed to conceptualisation, methodology. FT, NK, MKK contributed to data curation, writing-original draft preparation. FT contributed to supervision. FT, RDM, NK, MKK contributed to writing-reviewing and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.