Disparity Between Actual Case Volume and the Perceptions of Case Volume Needed to Train Competent General Surgeons

Background

Variances between resident expectations and faculty expectations may create conflict and/or dissatisfaction. The objective of this study was to determine if resident expectations of case requirements differed significantly from faculty expectations and/or national and program averages.

Methods

Residents and faculty members from 3 separate residency programs in Phoenix were sent an electronic survey and asked to indicate the number of operations as surgeon that should be performed by a resident during surgical residency in 34 categories in order to be deemed a competent general surgeon. The faculty and resident responses were compared with the average number of cases performed by graduating residents in these Phoenix programs and national means for 2007-2008.

Results

The resident response rate was 65% (55 of 84) and the faculty response rate was 80% (37 of 46). Residents' responses of necessary numbers of cases exceeded program averages in 76% of categories and national averages in 73% of categories. Faculty perceptions of necessary numbers of cases exceeded both program and national averages in 65% of categories. The largest discrepancies for both residents and faculty were their perceptions of the number of necessary cases of nonoperative trauma compared with the national mean (responses were 307% and 193% more respectively) and the number of cases of laparoscopic cholecystectomy compared with actual program averages (responses were 57% and 63% less respectively).

Conclusions

Resident and faculty perceptions of the number of cases needed for a competent graduating general surgery resident differ substantially from each other as well as from actual means. Improved education of each group to better align expectations with reality may improve satisfaction during training and confidence upon completion of training.

Key Words: residency, competence, case volume

Competency: Patient Care, Systems Based Practice, Practice-Based Learning and Improvement