National trends in minimally invasive and open operative experience of graduating general surgery residents: implications for surgical skills curricula development?
BACKGROUND
The aim of this study was to analyze national trends in minimally invasive and open cases of all graduating residents in general surgery.


METHODS
A retrospective analysis was performed on data obtained from Accreditation Council for Graduate Medical Education logs (1999-2008) of graduating residents from all US general surgery residency programs. Data were analyzed using Mantel-Haenszel χ(2) tests and the Bonferroni adjustment to detect trends in the number of minimally invasive and open cases.


RESULTS
Minimally invasive procedures accounted for an increasing proportion of cases performed (3.7% to 11.1%, P < .0001), with a proportional decrease in open cases. An increase in minimally invasive procedures with a proportional decrease in open procedures was noted in subcategories such as alimentary tract, abdominal, vascular, thoracic, and pediatric surgery (P < .0001).


CONCLUSIONS
The results of this study demonstrate that general surgery residents in the United States are performing a greater number of minimally invasive and fewer open procedures for common surgical conditions.
Department of Surgery, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
Jeffrey S
JS
Carson
Lynette
L
Smith
Madhuri
M
Are
James
J
Edney
Kenneth
K
Azarow
David W
DW
Mercer
Jon S
JS
Thompson
Chandrakanth
C
Are
D002321:Career Choice; D002983:Clinical Competence; D003479:Curriculum / Q000592:standards*; D004503:Education, Medical, Graduate / Q000639:trends*; D004521:Educational Measurement; D013502:General Surgery / Q000193:education* / Q000639:trends; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D019060:Minimally Invasive Surgical Procedures / Q000193:education / Q000639:trends*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000193:education / Q000639:trends*; D014481:United States