Trends in open abdominal exposure among vascular surgery trainees

Background This retrospective study evaluates the trends in open abdominal surgery cases among integrated vascular surgery residents compared with their 5 + 2 counterparts. Methods The Accreditation Council for Graduate Medical Education (ACGME) case logs between 2007 and 2016 were collected from a pool of 9861 residents and fellows from 371 institutions. Trainees were grouped into three categories: general surgery residency (GSR), integrated vascular surgery residency (IVSR), and vascular surgery fellowship in the United States. Inclusion criteria were specific to open abdominal cases of or including the anatomy adjacent to the aorta performed by the surgeon chief. Results The 5 + 2 graduates have obtained significantly more open vascular surgery training experience than their IVSR graduate counterparts (P <.01). GSR chief residents performed significantly more open abdomen cases than IVSR chief residents (P <.01). IVSR chiefs performed significantly more open vascular procedures than GSR chiefs (P <.01). On the completion of vascular surgery fellowship, 5 + 2 graduates had significantly more open abdominal aortic aneurysm (AAA) exposure during training than IVSR graduates did (P <.01); however, IVSR trainees had performed significantly more open AAA procedures than their GSR counterparts (P <.01). Conclusions Up to 2016, graduates of the 5 + 2 vascular training pathway had significantly higher open abdominal exposure than those of the IVSR track. However, graduates of the IVSR track had significantly higher open AAA exposure than GSR graduates.