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- Title
Impact of Integrated Vascular Surgery Residency on General Surgery Resident and Vascular Fellow Operative Volume: A National Analysis.
- Authors
Kim, Young; Cui, Christina L.; Williams, Zachary F.; Long, Chandler A.
- Abstract
Background: The impact of integrated vascular surgery (VS) residency (0 + 5) programs on general surgery (GS) resident and VS fellow (5 + 2) operative volume has not been investigated on a national scale. Methods: Accreditation Council for Graduate Medical Education (ACGME) case logs were reviewed for GS resident, VS resident, and VS fellow operative volume from 2001-2021. Integrated VS resident data was available from 2012-2021, corresponding with the introduction of the 0 + 5 paradigm. Trends in operative volume were evaluated via linear regression analysis. Results: The national cohort of chief GS resident graduates increased from 1005 to 1357 per year. Total operative volume also increased from 932 to 1039 cases (+7.4 cases/yr, R 2 =.80, P <.0001) among GS residents. Major vascular cases decreased among GS residents from 138 to 101 cases (−2.4 cases/yr, R 2 =.58, P <.0001) with a decrease in proportion of chief-level vascular cases from 30.4% to 11.9% (−1.0%/yr, R 2 =.92, P <.0001). Palliative procedures (amputations and hemodialysis access) comprised a significant proportion of GS cases (median 44.7%). Concurrently, integrated VS graduates increased from 11 to 37 per year, with an increase in major vascular case volume from 506 to 658 cases (+18.4 cases/yr, R 2 =.63, P =.01). Total VS fellow major case volume also increased from 369 to 444 cases (+3.5 cases/yr, R 2 =.73, P <.0001). Conclusions: The introduction of the 0 + 5 intgrated VS residency paradigm has correlated with a significant decrease in GS operative experience in major vascular procedures on a national level. Traditional VS fellow case volume does not appear to be impacted by 0 + 5 integrated residents. Further analysis with program-level data may help to explain the causative relationship of these findings.
- Subjects
HOSPITAL medical staff; REGRESSION analysis; ACQUISITION of data; VASCULAR surgery; INTERNSHIP programs; MEDICAL records; LONGITUDINAL method; PALLIATIVE treatment
- Publication
Vascular & Endovascular Surgery, 2024, Vol 58, Issue 3, p302
- ISSN
1538-5744
- Publication type
Article
- DOI
10.1177/15385744231213299