American Surgical Association

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Declining Resident Experience in Open Vascular Operations Threatens the Status of Vascular Surgery as an Essential Content Area of General Surgery Training
John R. Potts, III1, R. James Valentine2
1ACGME, Chicago, IL;2Vanderbilt University, Nashville, TN

OBJECTIVE(S): The ABS and the ACGME identify vascular surgery (VS) as an essential content area of general surgery (GS) training. With growth in the number of GS residents, proliferation of endovascular techniques and propagation of vascular training programs, GS residents may be performing fewer vascular operations. The purpose of this study was to examine trends in the number and type of open arterial vascular operations performed by GS residents.
METHODS: The annual National Data Report from ACGME Surgery Case Logs for completing GS residents in each AY from 2001-2 through 2015-6 were analyzed. The types and mean number of open arterial operations were recorded. Operations performed with endovascular technique, which entailed only en passant vascular ligation, which were limited to the venous system or for which the precise nature could not be determined were excluded from analysis. Logistic regression and ANOVA were performed using SAS software.
RESULTS: The total number of open arterial vascular procedures performed by GS residents significantly decreased over the study period. Highly significant decreases were noted in the following categories: aneurysm, cerebrovascular, peripheral obstructive, abdominal obstructive, extra-anatomic and trauma. Decreases also occurred in the miscellaneous and A-V access categories. A very small but statistically significant increase was noted in upper extremity procedures.
CONCLUSIONS: VS is currently considered essential to GS training. These data indicate that status may soon be in jeopardy.

Mean Number of Open Arterial Vascular Operations Reported by General Surgery Residents
Category2001-22005-62010-112015-6AdjRsqp
Aneurysm10.16.73.62.20.9609<.0001
Cerebrovascular22.516.312.610.40.9548<.0001
Peripheral Obstructive29.217.917.214.50.62500.0005
Abdominal Obstructive0.60.40.40.30.63710.0002
Extra-Anatomic3.02.31.91.70.9298<.0001
Trauma4.84.61.61.10.7880<.0001
Miscellaneous Vascular5.31.24.34.90.14480.1617
A-V Access32.038.432.129.90.25760.0554
TOTAL108.188.675.266.40.9462<.0001


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