• Kenneth L Abbott, Andrew E Krumm, Jesse K Kelley, Daniel E Kendrick, Michael J Clark, Xilin Chen, Tanvi Gupta, Andrew T Jones, Beatriz Ibaáñez Moreno, Gifty Kwakye, Nikki L Bibler Zaidi, David B Swanson, Richard H Bell, Brian C George, and Society for Improving Medical Professional Learning.
• Department of Surgery, Center for Surgical Training and Research, University of Michigan, Ann Arbor, Michigan.
• Ann. Surg. 2022 Dec 1; 276 (6): e1095e1100e1095-e1100.

ObjectiveTo examine the alignment between graduating surgical trainee operative performance and a prior survey of surgical program director expectations.BackgroundSurgical trainee operative training is expected to prepare residents to independently perform clinically important surgical procedures.MethodsWe conducted a cross-sectional observational study of US general surgery residents' rated operative performance for Core general surgery procedures. Residents' expected performance on those procedures at the time of graduation was compared to the current list of Core general surgery procedures ranked by their importance for clinical practice, as assessed via a previous national survey of general surgery program directors. We also examined the frequency of individual procedures logged by residents over the course of their training.ResultsOperative performance ratings for 29,885 procedures performed by 1861 surgical residents in 54 general surgery programs were analyzed. For each Core general surgery procedure, adjusted mean probability of a graduating resident being deemed practice-ready ranged from 0.59 to 0.99 (mean 0.90, standard deviation 0.08). There was weak correlation between the readiness of trainees to independently perform a procedure at the time of graduation and that procedure's historical importance to clinical practice ( p = 0.22, 95% confidence interval 0.01-0.41, P = 0.06). Residents also continue to have limited opportunities to learn many procedures that are important for clinical practice.ConclusionThe operative performance of graduating general surgery residents may not be well aligned with surgical program director expectations.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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