AAHS Annual Meeting
Back to main AAHS site
Annual Meeting Home
Final Program
2016 Annual Meeting Photos
Past & Future Meetings


Back to 2016 Annual Meeting Program


Resident Exposure to Peripheral Nerve Surgical Procedures During Residency Training
Joseph A. Gil, MD; Alan H. Daniels, MD; Edward Akelman, MD
Brown University, Providence, RI

Introduction: While the effects of resident and fellowship training and case volume on surgical competence are incompletely understood, variability in training for peripheral nerve procedures may exist between specialties. The objective of this study is to assess ACGME case log data for graduating orthopaedic surgery, plastic surgery, general surgery, and neurological surgery residents for peripheral nerve surgical procedures and to evaluate the level of intraspecialty and interspecialty variability of peripheral nerve procedure case volume.
Matieral & Methods: Accreditation Council for Graduate Medical Education surgical case logs from 2009 to 2014 for plastic surgery, orthopaedic surgery, neurological surgery and general surgery residency were assessed and compared for peripheral nerve surgery experience.
Results: The average number of total peripheral nerve procedures performed per graduating resident was 54.2 7.18 (95% CI, 48.4 to 59.9) for orthopaedic surgery residents, 62.8 8.04 (95% CI, 56.4 to 69.2) for residents from independent plastic surgery programs, 84.6 6.4 (95% CI, 56.4 to 69.2) for residents from integrated plastic surgery programs, 22.4 2.4 (95% CI, 18.5 to 26.4) for neurosurgery residents, and 0.4 0.24 (95% CI, 0.20 to 0.60) for general surgery residents. Intraspecialty comparison of the 10th and 90th percentile peripheral nerve case volume performed by orthopaedic surgery residents, neurological surgery residents and residents from independent and integrated plastic surgery programs in 2012 revealed remarkable variability in training. Within the orthopaedic surgery resident group, the bottom 10% reported 26 or fewer total peripheral nerve procedures per resident while the top 10% reported 102 or more, representing a 3.9 fold difference. Within the plastic surgery resident group from independent residencies, the bottom 10% reported 22 or fewer total peripheral nerve procedures per resident while the top 10% reported 111 or more, representing a 5.0-fold difference. Within the plastic surgery resident group from integrated residencies, the bottom 10% reported 21 or fewer total peripheral nerve procedures per resident while the top 10% reported 184 or more, representing a 8.8-fold difference. Within the neurological surgery resident group, the bottom 10% reported 6 or fewer total peripheral nerve procedures per resident while the top 10% reported 42 or more, representing a 7.0-fold difference.
Conclusions: There is significant interspecialty and intraspecialty variability in peripheral nerve surgery training for orthopaedic, plastic, neurological and general surgery trainees. Variability in residency training between the specialties is notable and may affect knowledge, skill, and practice patterns of surgeons.


Back to 2016 Annual Meeting Program
© 2018 American Association for Hand Surgery. Privacy Policy.