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Can my surgeon scope? Trends in endoscopy training volume and experience among general surgery residents in the United States: a nationwide analysis

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Abstract

Introduction

Endoscopy is a major part of surgical training. Accreditation Council for Graduate Medical Education (ACGME) has set standards regarding the minimum volume of endoscopy cases required for graduation. However, there is paucity of high-quality data on the number of cases that most surgical graduates perform.

Methods

We conducted a retrospective analysis of operative case logs of all general surgery residents graduating from ACGME-accredited programs from 2010 to 2023. Data on mean number of endoscopy cases, including mean in each subcategory, were retrieved. Mann–Kendall trend test was used to investigate trends in endoscopy experience.

Results

Between 2010 and 2023, the mean overall endoscopy procedures per resident remained stable, with 129.5 in 2010 and 132.1 in 2023 (t = 0.429; p-value = 0.037). The majority of these cases were performed as surgeon junior (76.6% in 2010; 80.9% in 2023), while the remaining cases were logged as surgeon chief. The most substantial contribution to the overall volume was from flexible colonoscopy (mean: 64.1 in 2010 and 67.2 in 2023). The volume for colonoscopy remained fairly stable (t = 0.429; p-value = 0.036). This was followed by esophagogastroduodenoscopy (mean: 35.3 in 2010 and 35.5 in 2023), which saw a significant increase in volume (t = 0.890; p-value ≤ 0.001). There was a significant increase in the number of overall upper endoscopic procedures (t = 0.791; p-value ≤ 0.001), while lower endoscopic procedures did not change significantly (t = 0.319; p-value = 0.125). The procedural volume for endoscopic retrograde cholangiography, sigmoidoscopy, cystoscopy/ureteroscopy, laryngoscopy, and bronchoscopy decreased significantly (p-value < 0.05 for all).

Conclusion

The overall endoscopy volume for general surgery residents has largely remained stable, with a minor increase in esophagogastroduodenoscopy and no change in colonoscopy. Future research should investigate whether simulation-based exercises can bridge the gap between procedural volume and learning curve requirements for endoscopy.

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Authors and Affiliations

  1. University of New Mexico School of Medicine, 1209 Dartmouth Dr NE, Albuquerque, NM, 87106, USA

    Amir Humza Sohail, Kevin Martinez, Hoang Nguyen, Samuel Flesner & Mohammed A. Quazi

  2. College of Arts and Sciences, University of New Mexico, Albuquerque, USA

    Christian Martinez

  3. Shifa College of Medicine, Islamabad, Pakistan

    Abdullah Khan

  4. Department of Internal Medicine, University of Kentucky, Lexington, KY, USA

    Waqas Rasheed

  5. Department of Medicine, East Carolina University, Greenville, NC, USA

    Hassam Ali

  6. Division of Gastroenterology, Hepatology and Motility, The University of Kansas School of Medicine, Kansas City, KS, USA

    Dushyant Singh Dahiya

  7. Department of Internal Medicine, University of Toledo, Toledo, OH, USA

    Manesh Kumar Gangwani & Muhammad Aziz

  8. Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India

    Aman Goyal

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  1. Amir Humza Sohail
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  2. Christian Martinez
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  13. Aman Goyal
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Corresponding author

Correspondence to Kevin Martinez.

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Disclosures

Amir Humza Sohail, Christian Martinez, Kevin Martinez, Hoang Nguyen, Sam Flesner, Abdullah Khan, Mohammed A Quazi, Waqas Rasheed, Hassam Ali, Dushyant Singh Dahiya, Manesh Kumar Gangwani, Muhammad Aziz, and Aman Goyal have no conflicts of interest or financial ties to disclose.

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Sohail, A.H., Martinez, C., Martinez, K. et al. Can my surgeon scope? Trends in endoscopy training volume and experience among general surgery residents in the United States: a nationwide analysis. Surg Endosc 38, 1491–1498 (2024). https://doi.org/10.1007/s00464-024-10690-5

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