title: 0 + 5 Vascular Surgery Residents' Operative Experience in General Surgery: An Analysis of Operative Logs from 12 Integrated Programs.
abstract: OBJECTIVE
  Integrated (0 + 5) vascular surgery (VS) residency programs must include 24 months of training in core general surgery. The Accreditation Council for Graduate Medical Education currently does not require specific case numbers in general surgery for 0 + 5 trainees; however, program directors have structured this time to optimize operative experience. The aim of this study is to determine the case volume and type of cases that VS residents are exposed to during their core surgery training.
  
  
  METHODS
  Accreditation council for graduate medical education operative logs for current 0 + 5 VS residents were obtained and retrospectively reviewed to determine general surgery case volume and distribution between open and laparoscopic cases performed. Standard statistical methods were applied.
  
  
  METHODS
  A total of 12 integrated VS residency programs provided operative case logs for current residents.
  
  
  METHODS
  A total of 41 integrated VS residents in clinical years 2 through 5.
  
  
  RESULTS
  During the postgraduate year-1 training year, residents participated in significantly more open than laparoscopic general surgery cases (p < 0.0001). This difference was consistent over the first 3 years of training. The most frequently logged open general surgery cases are hernia repair (20%), skin and soft tissue (7.4%), and breast (6.3%). Residents in programs with core surgery over 3 years participated in significantly more general surgery operations compared with residents in programs with core surgery spread out over 4 years (p = 0.035).
  
  
  CONCLUSIONS
  0 + 5 VS residents perform significantly more open operations than laparoscopic operations during their core surgery training. The majority of these operations are minor, nonabdominal procedures. The 0 + 5 VS residency program general surgery operative training requirements should be reevaluated and case minimums defined. The general surgery training component of 0 + 5 VS residencies may need to be restructured to meet the needs of current and future trainees.
authors: Division of Vascular Surgery, University of Utah, Salt Lake City, Utah. Electronic address: brigitte.smith@hsc.utah.edu.
authors: Brigitte K
authors: BK
authors: Smith
authors: Department of Surgery, University of Wisconsin, Madison, Wisconsin.
authors: P Chulhi
authors: PC
authors: Kang
authors: Department of Surgery, University of Wisconsin, Madison, Wisconsin.
authors: Chris
authors: C
authors: McAninch
authors: Department of Surgery, University of Wisconsin, Madison, Wisconsin.
authors: Glen
authors: G
authors: Leverson
authors: Department of Surgery, University of Wisconsin, Madison, Wisconsin.
authors: Sarah
authors: S
authors: Sullivan
authors: Division of Vascular Surgery, Oregon Health and Science University, Portland, Oregon.
authors: Erica L
authors: EL
authors: Mitchell
mesh_terms: D000068:Accreditation; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D010535:Laparoscopy / Q000193:education; D012189:Retrospective Studies; D014481:United States; D014656:Vascular Surgical Procedures / Q000193:education*; D016526:Workload / Q000706:statistics & numerical data*
keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Systems-Based Practice; operative experience; resident education; subspecialty training; technical competence; vascular surgery