title: An Analysis of Operative Experiences of Junior General Surgical Residents and Correlation With the SCORE Curriculum.
abstract: OBJECTIVE
  Junior surgical resident education at academic institutions is traditionally focused to preoperative and postoperative patient management. Our objective was to investigate the number and type of surgical procedures performed by junior general surgery residents in comparison with the American Board of Surgery requirements and the Surgical Council on Resident Education (SCORE) curriculum.
  
  
  METHODS
  This was a retrospective study using the Accreditation Counsel for Graduate Medical Education (ACGME) operative case logs of junior surgical residents.
  
  
  METHODS
  The Ohio State University Wexner Medical Center, Columbus, OH; a tertiary academic medical center.
  
  
  METHODS
  We performed, an institutional review board approved, retrospective review of logged surgical cases from general surgical residents during postgraduate year (PGY) 1 and 2 from 2009 to 2015 at an academic medical center. Summary case logs were accessed from the ACGME. Procedures were extracted from the SCORE curriculum and correlated to corresponding ACGME defined procedures for total cases, major cases, and endoscopy. Minor cases and patient care cases were excluded as they were not clearly defined on the category report. SCORE procedures were excluded if there was not a corresponding ACGME procedure on the summary report. SCORE procedures and ACGME procedures were combined with each other if there was overlap with correlation. Statistics were performed on individual and total resident data. One-sample student's t-test was used to compare total number of cases logged with the 250 case log ABS requirement and to compare the total major cases and endoscopy performed with those represented on SCORE.
  
  
  RESULTS
  Overall, 26 residents completed both PGY-1 and 2 years from 2009 to 2015, and remained at the same institution for case logs to be accessed during the study period. A total of 21 residents (80.76%) completed 250 cases or more after their first 2 years of residency. Across all years, the mean case log was 349 cases (p = 0.20), and was statistically more than than 250 cases in 3 of the 5 class years. Junior residents completed a total mean of 312 major and endoscopy cases (89%) at the end of 2 years, which was statistically higher than the 75% testing hypothesis across all years (p < 0.01). Of major and endoscopy cases performed in total by the completion of the PGY-2 year, a mean of 275 cases (88%) were included in the SCORE curriculum. Using one-sample t-test, SCORE procedures represented more than 85% of the major and endoscopy cases logged (p < 0.01). Of all major and endoscopy cases logged that correlate to a SCORE procedure, 95% were found to be "core" and 5% were "advanced."
  
  
  CONCLUSIONS
  Our study demonstrates that junior surgical residents meet the 250 case log requirement put forth by the ABS, and most major procedures and endoscopy performed correspond with the core cases of the SCORE curriculum at our institution. This study aid in the confirmation of the SCORE curriculum for junior residents, and those procedures which should be designated as core.
authors: Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address: david.strosberg@osumc.edu.
authors: David S
authors: DS
authors: Strosberg
authors: Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors: Kristen M
authors: KM
authors: Quinn
authors: Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors: Sherif R
authors: SR
authors: Abdel-Misih
authors: Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors: Alan E
authors: AE
authors: Harzman
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D003479:Curriculum / Q000592:standards*; D004503:Education, Medical, Graduate / Q000592:standards*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D008297:Male; D009820:Ohio; D058996:Quality Improvement; D012189:Retrospective Studies; D016526:Workload / Q000706:statistics & numerical data*
keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; SCORE curriculum; case log; junior residents; surgical education