Factors impacting neurosurgery residents’ operative case volume: a nationwide survey

Edward Burkhardt Department of Neurosurgery, Ochsner-Louisiana State University, Shreveport, Louisiana; and

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Nimer Adeeb Department of Neurosurgery, Ochsner-Louisiana State University, Shreveport, Louisiana; and

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Danielle Terrell Department of Neurosurgery, Ochsner-Louisiana State University, Shreveport, Louisiana; and

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Carlie Proctor Department of Neurosurgery, Ochsner-Louisiana State University, Shreveport, Louisiana; and

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Basel Musmar Department of Neurosurgery, Ochsner-Louisiana State University, Shreveport, Louisiana; and

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Christoph J. Griessenauer Department of Neurosurgery, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria

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Jennifer A. Kosty Department of Neurosurgery, Ochsner-Louisiana State University, Shreveport, Louisiana; and

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Bharat Guthikonda Department of Neurosurgery, Ochsner-Louisiana State University, Shreveport, Louisiana; and

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OBJECTIVE

Neurological surgery residency remains one of the most competitive and longest specialties in terms of training in medicine. The Accreditation Council for Graduate Medical Education uses residents’ case volume throughout residency as one of its measures for the quality of surgical training. The objective was to study the variability of residency case volume among US training programs and to analyze the factors that potentially influence that case volume.

METHODS

In line with the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines, an online survey regarding department size, case volume, number of residents per year, number of dedicated research years, presence of fellows, and resident case volume by the time of graduation was created using Google Forms and distributed to all neurosurgery residency program directors and coordinators in the US.

RESULTS

A total of 97 of the 115 programs (84.3%) responded to the survey. Fifteen programs were excluded due to missing data or incomplete resident cohort at the time of the survey, and a total of 82 programs were included in the analysis. The average number of cases performed by residents as lead or senior surgeons by the time of graduation ranged from 900 to 2250 (median 1600 cases). The resident case volume did not have a significant correlation with the program case volume, number of operating attending neurosurgeons, number of residents, number of research years, or presence of fellows. The only factor that impacted the resident case volume was the number of cases performed per faculty.

CONCLUSIONS

The number of cases performed by residents throughout residency varied significantly between programs. Although other factors play important roles in the quality of training, including autonomy, variation, and complexity of cases, the resident case volume is one of the only measurable factors. This study sheds some light on the factors that potentially influence neurosurgical resident case volume.

ABBREVIATIONS

ACGME = Accreditation Council for Graduate Medical Education; RRC = Residency Review Committee.

Supplementary Materials

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Illustration from Martini et al. (pp 386–392). Used with permission of Mayo Foundation for Medical Education and Research, all rights reserved.
  • 1

    Neurology and Neurosurgery Department History. Johns Hopkins Medicine. Accessed June 13, 2023. https://www.hopkinsmedicine.org/neurology_neurosurgery/about_us/history/index.html

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Yaeger KA, Munich SA, Byrne RW, Germano IM. Trends in United States neurosurgery residency education and training over the last decade (2009-2019). Neurosurg Focus. 2020;48(3):E6.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Antiel RM, Thompson SM, Hafferty FW, et al. Duty hour recommendations and implications for meeting the ACGME core competencies: views of residency directors. Mayo Clin Proc. 2011;86(3):185191.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Jagannathan J, Vates GE, Pouratian N, et al. Impact of the Accreditation Council for Graduate Medical Education work-hour regulations on neurosurgical resident education and productivity. J Neurosurg. 2009;110(5):820827.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Cohen-Gadol AA, Piepgras DG, Krishnamurthy S, Fessler RD. Resident duty hours reform: results of a national survey of the program directors and residents in neurosurgery training programs. Neurosurgery. 2005;56(2):398403.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Bina RW, Lemole GM Jr, Dumont TM. On resident duty hour restrictions and neurosurgical training: review of the literature. J Neurosurg. 2016;124(3):842848.

  • 7

    Dumont TM, Tranmer BI, Horgan MA, Rughani AI. Trends in neurosurgical complication rates at teaching vs nonteaching hospitals following duty-hour restrictions. Neurosurgery. 2012;71(5):10411046.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Babu MA, Nahed BV, Heary RF. Investigating the scope of resident patient care handoffs within neurosurgery. PLoS One. 2012;7(7):e41810.

  • 9

    Gladwell M. Outliers: The Story of Success. Little, Brown & Co.;2008.

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