Is Initial Board Certification Associated with Better Early-Career Surgical Outcomes?

Objective To determine if initial American Board of Surgery certification in general surgery is associated with better risk-adjusted patient outcomes for Medicare patients undergoing partial colectomy by an early career surgeon. Background Board certification is a voluntary commitment to professionalism, continued learning and delivery of high-quality patient care. Not all surgeons are certified, and some have questioned the value of certification due to limited evidence that board-certified surgeons have better patient outcomes. In response, we examined the outcomes of certified vs. non-certified early career general surgeons. Methods We identified Medicare patients who underwent a partial colectomy between 2008-2016 and were operated on by a non-subspecialty trained surgeon within their first 5 years of practice. Surgeon certification status was determined using American Board of Surgery data. Generalized linear mixed models were used to control for patient-, procedure- and hospital-level effects. Primary outcomes were the occurrence of severe complications and occurrence of death within 30 days. Results We identified 69,325 patients who underwent a partial colectomy by an early career general surgeon. The adjusted rate of severe complications after partial colectomy by certified (n = 4,239) vs. non-certified (n = 191) early-career general surgeons was 9.1% vs. 10.7% (OR 0.83, p = 0.03). Adjusted mortality rate for certified vs. non-certified early-career general surgeons was 4.9% vs. 6.1% (OR 0.79, p = 0.01). Conclusion Patients undergoing partial colectomy by an early career general surgeon have decreased odds of severe complications and death when their surgeon is board certified.