Longitudinal Changes in the Operative Experience for Junior Urology Residents
To evaluate longitudinal trends in surgical case volume among junior urology residents. There is growing perception that urology residents are not prepared for independent practice, which may be linked to decreased exposure to major cases early in residency. Retrospective review of deidentified case...
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| Veröffentlicht in: | Urology (Ridgewood, N.J.) N.J.), 2023-09, Vol.179, p.32-38 |
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| creator | Margolin, Ezra J. Schoenfeld, Daniel Miles, Caleb H. Merrill, Suzanne B. Raman, Jay D. Thompson, R. Houston Reese, Adam C. Parekh, Dipen J. Brown, Elizabeth T. Klausner, Adam Williams, Daniel H. Lee, Richard K. Zaslau, Stanley Guzzo, Thomas J. Shenot, Patrick J. Anderson, Christopher B. Badalato, Gina M. |
| description | To evaluate longitudinal trends in surgical case volume among junior urology residents. There is growing perception that urology residents are not prepared for independent practice, which may be linked to decreased exposure to major cases early in residency.
Retrospective review of deidentified case logs from urology residency graduates from 12 academic medical centers in the United States from 2010 to 2017. The primary outcome was the change in major case volume for first-year urology (URO1) residents (after surgery internship), measured using negative binomial regression.
A total of 391,399 total cases were logged by 244 residency graduates. Residents performed a median of 509 major cases, 487 minor cases, and 503 endoscopic cases. From 2010 to 2017, the median number of major cases performed by URO1 residents decreased from 64 to 49 (annual incidence rate ratio 0.90, P |
| doi_str_mv | 10.1016/j.urology.2023.03.064 |
| format | Article |
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Retrospective review of deidentified case logs from urology residency graduates from 12 academic medical centers in the United States from 2010 to 2017. The primary outcome was the change in major case volume for first-year urology (URO1) residents (after surgery internship), measured using negative binomial regression.
A total of 391,399 total cases were logged by 244 residency graduates. Residents performed a median of 509 major cases, 487 minor cases, and 503 endoscopic cases. From 2010 to 2017, the median number of major cases performed by URO1 residents decreased from 64 to 49 (annual incidence rate ratio 0.90, P < .001). This trend was limited to oncology cases, with no change in reconstructive or pediatric cases. The number of major cases decreased more for URO1 residents than for residents at other levels (P-values for interaction <.05). The median number of endoscopic cases performed by URO1 residents increased from 85 to 194 (annual incidence rate ratio 1.09, P < .001), which was also disproportionate to other levels of residency (P-values for interaction <.05).
There has been a shift in case distribution among URO1 residents, with progressively less exposure to major cases and an increased focus on endoscopic surgery. Further investigation is needed to determine if this trend has implications on the surgical proficiency of residency graduates.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/j.urology.2023.03.064</identifier><identifier>PMID: 37400019</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Child ; Clinical Competence ; Education, Medical, Graduate ; General Surgery - education ; Humans ; Internship and Residency ; Retrospective Studies ; United States ; Urology - education</subject><ispartof>Urology (Ridgewood, N.J.), 2023-09, Vol.179, p.32-38</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c313t-34ee8ee2f25f25c9adce7ce4091017cc8ce7d596a68796404de55eaab6d040523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.urology.2023.03.064$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37400019$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Margolin, Ezra J.</creatorcontrib><creatorcontrib>Schoenfeld, Daniel</creatorcontrib><creatorcontrib>Miles, Caleb H.</creatorcontrib><creatorcontrib>Merrill, Suzanne B.</creatorcontrib><creatorcontrib>Raman, Jay D.</creatorcontrib><creatorcontrib>Thompson, R. Houston</creatorcontrib><creatorcontrib>Reese, Adam C.</creatorcontrib><creatorcontrib>Parekh, Dipen J.</creatorcontrib><creatorcontrib>Brown, Elizabeth T.</creatorcontrib><creatorcontrib>Klausner, Adam</creatorcontrib><creatorcontrib>Williams, Daniel H.</creatorcontrib><creatorcontrib>Lee, Richard K.</creatorcontrib><creatorcontrib>Zaslau, Stanley</creatorcontrib><creatorcontrib>Guzzo, Thomas J.</creatorcontrib><creatorcontrib>Shenot, Patrick J.</creatorcontrib><creatorcontrib>Anderson, Christopher B.</creatorcontrib><creatorcontrib>Badalato, Gina M.</creatorcontrib><title>Longitudinal Changes in the Operative Experience for Junior Urology Residents</title><title>Urology (Ridgewood, N.J.)</title><addtitle>Urology</addtitle><description>To evaluate longitudinal trends in surgical case volume among junior urology residents. There is growing perception that urology residents are not prepared for independent practice, which may be linked to decreased exposure to major cases early in residency.
Retrospective review of deidentified case logs from urology residency graduates from 12 academic medical centers in the United States from 2010 to 2017. The primary outcome was the change in major case volume for first-year urology (URO1) residents (after surgery internship), measured using negative binomial regression.
A total of 391,399 total cases were logged by 244 residency graduates. Residents performed a median of 509 major cases, 487 minor cases, and 503 endoscopic cases. From 2010 to 2017, the median number of major cases performed by URO1 residents decreased from 64 to 49 (annual incidence rate ratio 0.90, P < .001). This trend was limited to oncology cases, with no change in reconstructive or pediatric cases. The number of major cases decreased more for URO1 residents than for residents at other levels (P-values for interaction <.05). The median number of endoscopic cases performed by URO1 residents increased from 85 to 194 (annual incidence rate ratio 1.09, P < .001), which was also disproportionate to other levels of residency (P-values for interaction <.05).
There has been a shift in case distribution among URO1 residents, with progressively less exposure to major cases and an increased focus on endoscopic surgery. Further investigation is needed to determine if this trend has implications on the surgical proficiency of residency graduates.</description><subject>Child</subject><subject>Clinical Competence</subject><subject>Education, Medical, Graduate</subject><subject>General Surgery - education</subject><subject>Humans</subject><subject>Internship and Residency</subject><subject>Retrospective Studies</subject><subject>United States</subject><subject>Urology - education</subject><issn>0090-4295</issn><issn>1527-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkF1LwzAUhoMoOqc_QemlN52naZI2VyLDTyYDcdchJqczo2tn0or790Y7vRVeOOfAe74eQs4ymGSQicvVpPdt3S63Ewo0n0CUYHtklHFapFJKvk9GABJSRiU_IschrABACFEckqO8YLHI5Ig8zdpm6breukbXyfRNN0sMiWuS7g2T-Qa97twHJjefMXXYGEyq1iePfeNiWAwXJM8YnMWmCyfkoNJ1wNNdHJPF7c3L9D6dze8eptez1ORZ3qU5QywRaUV5lJHaGiwMMpDxtcKYMpaWS6FFWUjBgFnkHLV-FRYYcJqPycUwd-Pb9x5Dp9YuGKxr3WDbB0XLPAfKypJHKx-sxrcheKzUxru19luVgfomqVZqR1J9k1QQJVjsO9-t6F_XaP-6ftFFw9VgwPjoh0OvgvkhZJ1H0ynbun9WfAElXYhI</recordid><startdate>202309</startdate><enddate>202309</enddate><creator>Margolin, Ezra J.</creator><creator>Schoenfeld, Daniel</creator><creator>Miles, Caleb H.</creator><creator>Merrill, Suzanne B.</creator><creator>Raman, Jay D.</creator><creator>Thompson, R. 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Houston ; Reese, Adam C. ; Parekh, Dipen J. ; Brown, Elizabeth T. ; Klausner, Adam ; Williams, Daniel H. ; Lee, Richard K. ; Zaslau, Stanley ; Guzzo, Thomas J. ; Shenot, Patrick J. ; Anderson, Christopher B. ; Badalato, Gina M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c313t-34ee8ee2f25f25c9adce7ce4091017cc8ce7d596a68796404de55eaab6d040523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Child</topic><topic>Clinical Competence</topic><topic>Education, Medical, Graduate</topic><topic>General Surgery - education</topic><topic>Humans</topic><topic>Internship and Residency</topic><topic>Retrospective Studies</topic><topic>United States</topic><topic>Urology - education</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Margolin, Ezra J.</creatorcontrib><creatorcontrib>Schoenfeld, Daniel</creatorcontrib><creatorcontrib>Miles, Caleb H.</creatorcontrib><creatorcontrib>Merrill, Suzanne B.</creatorcontrib><creatorcontrib>Raman, Jay D.</creatorcontrib><creatorcontrib>Thompson, R. Houston</creatorcontrib><creatorcontrib>Reese, Adam C.</creatorcontrib><creatorcontrib>Parekh, Dipen J.</creatorcontrib><creatorcontrib>Brown, Elizabeth T.</creatorcontrib><creatorcontrib>Klausner, Adam</creatorcontrib><creatorcontrib>Williams, Daniel H.</creatorcontrib><creatorcontrib>Lee, Richard K.</creatorcontrib><creatorcontrib>Zaslau, Stanley</creatorcontrib><creatorcontrib>Guzzo, Thomas J.</creatorcontrib><creatorcontrib>Shenot, Patrick J.</creatorcontrib><creatorcontrib>Anderson, Christopher B.</creatorcontrib><creatorcontrib>Badalato, Gina M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urology (Ridgewood, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Margolin, Ezra J.</au><au>Schoenfeld, Daniel</au><au>Miles, Caleb H.</au><au>Merrill, Suzanne B.</au><au>Raman, Jay D.</au><au>Thompson, R. Houston</au><au>Reese, Adam C.</au><au>Parekh, Dipen J.</au><au>Brown, Elizabeth T.</au><au>Klausner, Adam</au><au>Williams, Daniel H.</au><au>Lee, Richard K.</au><au>Zaslau, Stanley</au><au>Guzzo, Thomas J.</au><au>Shenot, Patrick J.</au><au>Anderson, Christopher B.</au><au>Badalato, Gina M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Longitudinal Changes in the Operative Experience for Junior Urology Residents</atitle><jtitle>Urology (Ridgewood, N.J.)</jtitle><addtitle>Urology</addtitle><date>2023-09</date><risdate>2023</risdate><volume>179</volume><spage>32</spage><epage>38</epage><pages>32-38</pages><issn>0090-4295</issn><eissn>1527-9995</eissn><abstract>To evaluate longitudinal trends in surgical case volume among junior urology residents. There is growing perception that urology residents are not prepared for independent practice, which may be linked to decreased exposure to major cases early in residency.
Retrospective review of deidentified case logs from urology residency graduates from 12 academic medical centers in the United States from 2010 to 2017. The primary outcome was the change in major case volume for first-year urology (URO1) residents (after surgery internship), measured using negative binomial regression.
A total of 391,399 total cases were logged by 244 residency graduates. Residents performed a median of 509 major cases, 487 minor cases, and 503 endoscopic cases. From 2010 to 2017, the median number of major cases performed by URO1 residents decreased from 64 to 49 (annual incidence rate ratio 0.90, P < .001). This trend was limited to oncology cases, with no change in reconstructive or pediatric cases. The number of major cases decreased more for URO1 residents than for residents at other levels (P-values for interaction <.05). The median number of endoscopic cases performed by URO1 residents increased from 85 to 194 (annual incidence rate ratio 1.09, P < .001), which was also disproportionate to other levels of residency (P-values for interaction <.05).
There has been a shift in case distribution among URO1 residents, with progressively less exposure to major cases and an increased focus on endoscopic surgery. Further investigation is needed to determine if this trend has implications on the surgical proficiency of residency graduates.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37400019</pmid><doi>10.1016/j.urology.2023.03.064</doi><tpages>7</tpages></addata></record> |
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| subjects | Child Clinical Competence Education, Medical, Graduate General Surgery - education Humans Internship and Residency Retrospective Studies United States Urology - education |
| title | Longitudinal Changes in the Operative Experience for Junior Urology Residents |
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