An Interval Look at the Transplant Surgery Pipeline: Insights from General Surgery Residents? Operative Experience Using ACGME Operative Logs from 2000 to 2021

OBJECTIVE: Given the declining number of US graduates pursuing transplant surgery as well as regulatory changes regarding transplant rotations for surgical resi-dents, this study examined the transplant surgery opera-tive volume of residents over the past 20 years.DESIGN: Retrospective analysis of the ACGME database of general surgery operative logs from academic year (AY) 1999-2000 to AY 2020-2021; data was categorized into time periods relative to regulatory changes: Period 1 (1999-2010) and Period 2 (2011-2021). SETTING/PARTICIPANTS: All ACGME-accredited gen-eral surgery residency programs in the US.FINDINGS: On average, the proportion of transplant cases to all total major cases was about 1% and did not change during the study period (p=0.61). Each graduat-ing resident completed an average of 10.0 +/- 11.0 cases during Period 1 and 10.8 +/- 12.0 cases during Period 2, representing a statistically but unlikely clinically signifi-cant increase (p=0.008). Renal transplants comprised more than 50% of each resident's operative experience in transplant surgery. The proportion of resident involve-ment in all renal and liver transplantations nationally did not change during the study period, ranging from 34.5-42.9% for renal and 13.8-22.4% for liver. CONCLUSIONS: Resident volume in transplant surgery has largely remained consistent over the past 20 years, suggesting that changes in operative volume are unlikely driving declining interest in transplant surgery fellow-ship among US trainees. ( J Surg Ed 80:511-519. (c) 2022 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Automated summary

This study retrospectively analyzed the operative volume of transplant surgery residents from 1999 to 2021 using the ACGME database. The findings suggest that the number of transplant cases and resident involvement in transplant surgeries have remained consistent over the past 20 years, indicating that changes in operative volume are unlikely to be the cause of declining interest in transplant surgery among US trainees.