39.09 Better ABSITE Performance with Increased Operative Case Load During Surgical Residency

A. R. Marcadis¹, T. Spencer¹, D. Sleeman¹, O. C. Velazquez¹, J. I. Lew^{1  1}University Of Miami,DeWitt Daughtry Family Department Of Surgery,Miami, FL, USA

Introduction: Common measures of evaluating surgical resident progression during General Surgery residency include American Board of Surgery In-Training Exam (ABSITE) scores and operative case logs. It remains unknown, however, if there is an association between operative case numbers and resident ABSITE performance. This study evaluates the relationship between operative cases performed and ABSITE scores at both the junior and chief resident levels. 

Methods: A retrospective review of ABSITE scores and operative case logs was performed for categorical General Surgery residents at a single institution at the junior (post graduate year [PGY]-2, n=45, from 2009-2017) and chief (PGY-5, n=19, from 2014-2016) levels. For each surgical resident, total number of operative cases logged (major and minor) from the start of their PGY-1 year until the end of either their 2^nd or 5^th year was calculated and compared to their ABSITE percentile score for that corresponding year using unpaired t-test and linear regression. Outliers with operative cases logged >3 standard deviations from the mean were excluded.

Results:  There was a linear relationship between total number of operative cases logged and ABSITE percentile score for surgical residents at both the junior (slope, m = 1.295) and chief resident (m = 6.109) levels, with a higher number of total operative cases logged being significantly associated with higher ABSITE percentile scores. For both junior and chief residents, there was a statistically significant difference in average number of operative cases logged between those with ABSITE scores below the 50^th percentile and those with scores above the 50^th percentile (junior cases, 311 vs. 370, p<0.05;  and chief cases, 1352 vs. 1683, p<0.05), respectively.

Conclusion: Surgical residents who perform higher numbers of operative cases do significantly better on the ABSITE than their peers with lower operative case numbers. This association may be due to increased clinical experience, exposure to pathology and/or individual surgical resident motivation.