Neuzil Kevin, Wallen Eric, Potts John R, DeWitt-Foy Molly E
Department of Urology, University of North Carolina, Chapel Hill, NC, USA.
Department of Urology, Medical University of South Carolina, Charleston, SC, USA.
Transl Androl Urol. 2025 Aug 30;14(8):2358-2364. doi: 10.21037/tau-2025-55. Epub 2025 Aug 26.
Urologic surgical training has been dramatically affected by numerous practice changes including a significant increase in robotic surgery, rise of subspecialty fellows, and even the coronavirus disease 2019 (COVID-19) pandemic, among others. How resident training has been affected is not well understood. In this study, we aim to describe the changes in resident-reported case log data for reconstructive urology surgeries, specifically for female reconstructive cases.
Data were obtained from the Accreditation Council for Graduate Medical Education (ACGME) reporting system, which compiles resident-submitted case reports of procedures performed and resident role. Submitted surgeries are categorized by type using Current Procedural Terminology (CPT) codes as well as resident-reported role in the procedure-"surgeon", "assistant", "teaching assistant", or "all roles". Data from graduating urologic residents from 2010 to 2022 were reviewed.
From 2010 to 2022, we observed an increase in "all roles" reconstructive urologic cases logged by residents (0.82 cases per year, P=0.06). Reconstructive cases logged as "surgeon" decreased by 0.77 cases per year (P=0.057), while "assistant" cases increased by 1.48 cases per year (P<0.001). For female reconstructive cases, "surgeon" reported cases declined by 1.1 cases annually (P<0.001) while "assistant" role increased by 0.32 (P<0.001).
Over the last decade, we observed a decrease in resident-reported role as "surgeon" in female reconstructive cases while the overall volume of reconstructive urologic cases simultaneously increased. Understanding these trends is essential for resident educators, while further research is necessary to identify potential causes.
泌尿外科手术培训受到了众多实践变化的显著影响，包括机器人手术的大幅增加、专科住院医师人数的上升，甚至还有2019年冠状病毒病（COVID-19）大流行等。住院医师培训受到了怎样的影响尚未得到充分了解。在本研究中，我们旨在描述住院医师报告的重建泌尿外科手术病例记录数据的变化，特别是女性重建病例的数据。
数据来自毕业后医学教育认证委员会（ACGME）报告系统，该系统汇总了住院医师提交的所实施手术的病例报告以及住院医师在手术中的角色。提交的手术按类型使用当前操作术语（CPT）编码进行分类，同时还包括住院医师报告的在手术中的角色——“主刀医生”、“助手”、“带教助手”或“所有角色”。对2010年至2022年毕业的泌尿外科住院医师的数据进行了审查。
从2010年到2022年，我们观察到住院医师记录的“所有角色”重建泌尿外科病例有所增加（每年0.82例，P = 0.06）。记录为“主刀医生”的重建病例每年减少0.77例（P = 0.057），而“助手”病例每年增加1.48例（P < 0.001）。对于女性重建病例，报告为“主刀医生”的病例每年减少1.1例（P < 0.001），而“助手”角色增加0.32例（P < 0.001）。
在过去十年中，我们观察到住院医师报告的女性重建病例中“主刀医生”角色减少，而重建泌尿外科病例的总体数量同时增加。了解这些趋势对住院医师教育工作者至关重要，同时需要进一步研究以确定潜在原因。
