• Al-Faraaz Kassam, Caroline A Lynch, Alexander R Cortez, Dennis Vaysburg, John R Potts, and R Cutler Quillin.
• Cincinnati Research on Education in Surgical Training (CREST), Cincinnati, Ohio; University of Cincinnati, Department of Surgery, Cincinnati, Ohio. Electronic address: kassamaz@ucmail.uc.edu.
• J Surg Educ. 2021 Jan 1; 78 (1): 9-16.

ObjectivesThe operative experience of today's general surgery (GS) residents are changing. The Surgical Council on Resident Education (SCORE) was founded to provide a standardized, competency-based curriculum. We set out to evaluate resident operative experience in core and advanced operations.DesignAccreditation Council for Graduate Medical Education (ACGME) national operative log reports from 2010 to 2018 were reviewed. Operative volume data for 344 operations were extracted and analyzed. Operations were designated as core, advanced, or undefined as listed by SCORE, and stratified as GS or subspecialty.SettingNational analysis utilizing ACGME operative log reports.ParticipantsAll graduating general surgery residents between 2010 and 2018.ResultsA total of 10,118 residents completed GS training with an average of 1121.5 ± 29.3 total cases. Core operations comprised 80.5% of total volume while advanced comprised only 8.0%. The total core experience increased (+7.0 cases/year), while total advanced experience decreased (-1.4 cases/year) (p < 0.01 each). Compositional analysis among core operations revealed an increase in 9/13 GS domains and a decrease in 8/10 subspecialty domains (all p < 0.05).ConclusionsThere has been an increase in core operative experience with a concurrent decrease in advanced operative experience of graduating GS residents. These findings highlight the continued narrowing of the operative experience for trainees, with increasing focus on GS and less on subspecialty domains. Ongoing efforts to look beyond operative volume to ensure competency of graduates will prove beneficial.Copyright © 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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