The Impact of Integrated Thoracic Residency on General Surgery Residents' Thoracic Operative Volume.

Abstract Background Integrated thoracic surgery (I-6) programs have become popular over traditional general surgery (GS) pathways since their inception in 2007. However, the effect of I-6 programs on general surgery resident training remains unknown. The purpose of this study was to evaluate the effect of I-6 programs on the thoracic operative experience of co-located general surgery residents. Methods Thoracic surgery cases recorded by residents in general surgery programs co-located with I-6 programs until 2019 were analyzed. Cases were reviewed five years prior to-through five years after the matriculation of the first thoracic resident in the co-located I-6 program. To contextualize the overall trends in the field, Accreditation Council for Graduate Medical Education (ACGME) general surgery resident case logs from 1990 to 2018 were analyzed and total thoracic surgery cases recorded. Statistical analysis was performed with linear regression. Results Residents in 19 GS programs with co-located I-6 programs showed an increase in total thoracic cases from 3710 to 4451 (Δ/year of +85.05 cases/year; p=0.03) balanced by an increase in GS residents from 107 to 126 (Δ/year of +1.45; p=0.01) such that there was no significant overall change in the median thoracic operative case volume (31.00 at both TSR-5 and TSR+5). Nationally, from 1990 to 2018, there was no change in the total thoracic operative experience for GS graduates. Conclusions The introduction of I-6 programs did not negatively impact thoracic operative experience for residents in co-located GS programs. Adequate training of both I-6 and GS residents at the same institution is feasible.