Inter-Resident Variability in Urologic Operative Case Volumes Over Time: A Review of the ACGME Case Logs from 2009-2016.

Objectives To assess the effect of the changing landscape of urologic residency education and training on resident operative exposure and inter-resident variability. Methods The Accreditation Council for Graduate Medical Education (ACGME) case logs for graduating urology chief residents were reviewed from Academic Year (AY) 2009-10 to 2016-17. Cases were stratified into the four ACGME categories – general urology, endourology, oncology, and reconstruction. Linear regression models analyzed the association between training year, volume, and type of cases performed. Inter-resident variability in case exposure was calculated by the difference between the ACGME reported 10th and 90th percentiles. Results During the study period, the mean number of cases performed per resident was 1092 (SD 32.7). Although there was no significant change in total case volume, there were changes within case categories. Endoscopic, retroperitoneal oncology, and male reconstruction case volume all increased significantly (Δ20.1%, Δ 5.1%, Δ 8.2%, respectively, all p Conclusions From AY2009-10 to 2016-17, residency case volume has remained constant, but there has been a change in types of cases performed and proliferation of minimally invasive techniques. Significant variability of inter-resident operative experience was noted.