Longitudinal Analysis of Peripheral Nerve Surgery Training: Comparison of Neurosurgery to Plastic and Orthopedic Surgery

Residents in multiple surgical specialties are trained to perform peripheral nerve surgery (PNS), but the extent of exposure to this field varies among specialties. This study evaluates trends in volume of PNS performed during residency for neurologic surgery trainees compared to those in plastic and orthopedic surgery between 2009 and 2019. We queried ACGME for neurologic, plastic, and orthopedic surgery resident case-logs and compared mean number of PNS between graduating residents of each specialty using a one-way analysis of variance test. Linear regression was utilized to determine trends within and across the specialties over the study period. Neurosurgery residents (24.76 ± 3.41) performed significantly fewer PNS than their counterparts in orthopedic (54.56 ± 6.85) and plastic surgery (71.96 ± 12.20), P < 0.001. Residents in neurologic surgery reported over 1.5-fold as many cases as their ACGME-required minimum, in contrast to plastic (2.5-fold) and orthopedic (5-fold). Plastics residents (3.46 cases/year) demonstrated the greatest longitudinal increase in PNS, followed by neurosurgery residents (0.81 cases/year). PNS accounted for a mean of 5.81% of neurosurgery resident cases, 4.20% of plastic surgery resident cases, and 2.98% of orthopedic surgery resident cases (P < 0.001). Neurosurgery residents exceeded the required minimum number of PNS and were increasingly more exposed to PNS. However, compared with their counterparts in orthopedic and plastic surgery, neurosurgery residents performed significantly fewer cases. Exposure for neurosurgery residents remains unchanged over the study period while plastic surgery residents experienced an increase in case volume. The deficiency in exposure for neurosurgical residents must be addressed to harness interest and proficiency in PNS.