The Fellowship Effect: Does Surgical Subspecialty Training Affect Pediatric Surgery Case Volume?

Purpose The Accreditation Council for Graduate Medical Education (ACGME) monitors fellow case numbers. Previous literature has shown new fellowships detrimentally affecting general surgery residency case numbers. We hypothesize that an increase in pediatric otolaryngology and pediatric urology fellowships would decrease overlapping case numbers in pediatric surgery fellowships. Materials and Methods A review of each specialties’ fellowship match results was performed. Publicly available pediatric surgery cases logs were reviewed for overlapping cases including thyroidectomy, parathyroidectomy, branchial cleft cyst excision, thyroglossal duct cyst excision, major neck tumor excision, nephrectomy, orchidopexy, inguinal hernia, and testicular torsion. Analyzed data included average case numbers and number of fellows each year. Linear regression analysis was performed. Results We identified a significant increase in fellowship graduates from 2003 to 2018 (p Conclusions Despite the increase in number of fellowships, there has been a minimal overall effect on pediatric surgery case volume. Continuing to monitor these trends will help ensure adequate training for all pediatric surgical subspecialties.