Minimum Extremes in Otolaryngology Resident Surgical Case Numbers

Abstract

Objective: 1) Understand the significance between the mean and minimum case numbers for surgical procedures among otolaryngology residents nationwide. 2) Understand potential weaknesses of the ACGME resident case log system and possible errors contributing to inaccurate data. 3) Understand educational definitions of competency and proficiency.

Method: Retrospective review of otolaryngology resident national data reports from ACGME resident case log system for three academic years (2007-2010). Minimum, mean, and standard deviation about the mean for total number of cases and for specific surgical procedures were compared. Comparison of “tracked” vs “untracked” CPT codes was also performed.

Results: The total number of cases for residents graduating from 2008 to 2010 remained fairly constant, ranging from a mean of 1701.5 ± 486 in 2008 to 1772.2 ± 517 in 2010. The minimum total number of cases also remained somewhat constant, ranging from 730 in 2009 to 811 in 2008, with these values falling approximately two standard deviations below the mean for most years. Comparison of case numbers for procedures such as parotidectomy, thyroidectomy, mastoidectomy, and endoscopic sinonasal surgeries, among others, yielded similar results. “Tracked” CPT codes tended to be fewer than “untracked” CPT codes for some surgical procedures.

Conclusion: Large differences between the mean and minimum case numbers for resident surgical procedures exist. Establishing minimum case number requirements for otolaryngology residents should be considered. Closer critical examination of the ACGME resident case log system and resident documentation habits is needed to improve accuracy of reporting.