title: Does operative experience during residency correlate with reported competency of recent general surgery graduates?
abstract: BACKGROUND
  Identification of attributes of residency training that predict competency would improve surgical education. We hypothesized that case experience during residency would correlate with self-reported competency of recent graduates.
  
  
  METHODS
  Aggregate case log data of residents enrolled in 2 general surgery programs were collected over a 12-month period and stratified into Surgical Council on Resident Education (SCORE) categories. We surveyed recent (< 5 yr) residency graduates on procedural competency. Resident case volumes were correlated with survey responses by SCORE category.
  
  
  RESULTS
  In all, 75 residents performed 11 715 operations, which were distributed by SCORE category as follows: essential-common (EC) 9935 (84.8%), essential-uncommon (EU) 889 (7.6%) and complex 891 (7.6%). Alimentary tract procedures were the most commonly performed EC (2386, 24%) and EU (504, 56.7%) procedures. The least common EC procedure was plastic surgery (4, 0.04%), and the least common EU procedure was abdomen-spleen (1, 0.1%). The questionnaire response rate was 45%. For EC procedures, self-reported competency was highest in skin and soft tissue, thoracic and head and neck (each 100%) and lowest in vascular-venous (54%), whereas for EU procedures it was highest in abdomen-general (100%) and lowest in vascular-arterial (62%). The correlation between case volume and self-reported competency was poor (R = 0.2 for EC procedures).
  
  
  CONCLUSIONS
  Self-reported competency correlates poorly with operative case experience during residency. Other curriculum factors, including specific rotations and timing, balance between inpatient and outpatient surgical experience and competition for cases, may contribute to procedural competency acquisition during residency.
authors.affiliation: Department of Surgery, University of British Columbia, Vancouver, B.C.
authors.forename: Arash
authors.initials: A
authors.lastname: Safavi
authors.forename: Sarah
authors.initials: S
authors.lastname: Lai
authors.forename: Sonia
authors.initials: S
authors.lastname: Butterworth
authors.forename: Morad
authors.initials: M
authors.lastname: Hameed
authors.forename: Dan
authors.initials: D
authors.lastname: Schiller
authors.forename: Erik
authors.initials: E
authors.lastname: Skarsgard
mesh_terms: D000328:Adult; D001955:British Columbia; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000458:organization & administration; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D058028:Research Report; D012647:Self-Assessment; D013997:Time Factors; D016526:Workload / Q000706:statistics & numerical data*