title: Trends in operative experience of pediatric surgical residents in the United States and Canada.
abstract: OBJECTIVE
  Expansion of the number of training programs in pediatric surgery occurred from 2003 through 2010. We sought to determine the effect of program expansion on case volume and distribution of operative experience.
  
  
  METHODS
  Public domain data on pediatric surgery resident summary statistics available from the Accreditation Council for Graduate Medical Education (ACGME) from July 2003 through June 2010 were analyzed. Total case volume as primary surgeon or teaching assistant, mean case volume per resident, standard deviation, mode, minimum, and maximum number of cases per resident were evaluated. Mean total cases per resident, minimally invasive laparoscopic and thoracoscopic cases, and requisite cases as defined by the ACGME categories of: tumor, important pediatric surgical, and neonatal cases were analyzed by a Cuzick Wilcoxon-type nonparametric trend statistic using a significance level of 0.05. Skew was assessed by Pearson coefficient with levels of -0.5 to 0.5 defining a parametric distribution.
  
  
  RESULTS
  The number of pediatric surgical training residents increased by 42% during the years reported, from 24 to 34. No statistically significant difference was found in the mean number of total cases or requisite cases per resident. The mean volume of minimally invasive procedures increased significantly. Case volume per resident was non-parametrically distributed with increasing positive skew over time.
  
  
  CONCLUSIONS
  The increase in number of pediatric surgical resident training positions has not adversely affected overall operative experience or exposure to highly specialized requisite cases, on average. The increasing positive skew of total and index cases, however, suggests that variability between programs in case exposure is increasing over time.
authors: Division of Pediatric Surgery, Columbia University College of Physicians and Surgeons and Morgan Stanley Children's Hospital of New York-Presbyterian, New York, NY 10032, USA. af2451@columbia.edu
authors: Abbey L
authors: AL
authors: Fingeret
authors: Charles J H
authors: CJ
authors: Stolar
authors: Robert A
authors: RA
authors: Cowles
mesh_terms: D002170:Canada; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data / Q000639:trends*; D010372:Pediatrics / Q000193:education*; D013514:Surgical Procedures, Operative / Q000193:education / Q000706:statistics & numerical data / Q000639:trends*; D014481:United States; D016526:Workload / Q000706:statistics & numerical data*