The Accreditation Council for Graduate Medical Education (ACGME) Resident Case Log System is designed to be a reflection of residents’ operative volume and an objective measure of their surgical experience. All operative procedures and manipulations in the operating room, Emergency Department, and outpatient clinic are to be logged into the Resident Case Log System. Discrepancies in the log volumes between residents and residency programs often prompt scrutiny. However, it remains unclear if such disparities truly represent differences in operative experiences or if they are reflections of inconsistent logging practices. The purpose of this study was to investigate individual recording practices among orthopaedic surgery residents prior to August 1, 2011.Methods:
Orthopaedic surgery residents received a questionnaire on case log practices that was distributed through the Council of Orthopaedic Residency Directors list server. Respondents were asked to respond anonymously about recording practices in different clinical settings as well as types of cases routinely logged. Hypothetical scenarios of common orthopaedic procedures were presented to investigate the differences in the Current Procedural Terminology codes utilized.Results:
Two hundred and ninety-eight orthopaedic surgery residents completed the questionnaire; 37% were fifth-year residents, 22% were fourth-year residents, 18% were third-year residents, 15% were second-year residents, and 8% were first-year residents. Fifty-six percent of respondents reported routinely logging procedures performed in the Emergency Department or urgent care setting. Twenty-two percent of participants routinely logged procedures in the clinic or outpatient setting, 20% logged joint injections, and only 13% logged casts or splints applied in the office setting. There was substantial variability in the Current Procedural Terminology codes selected for the seven clinical scenarios.Conclusions:
There has been a lack of standardization in case-logging practices among orthopaedic surgery residents prior to August 1, 2011. ACGME case log data prior to this date may not be a reliable measure of residents’ procedural experience.Peer Review
This article was reviewed by the Editor-in-Chief and one Deputy Editor, and it underwent blinded review by two or more outside experts. The Deputy Editor reviewed each revision of the article, and it underwent a final review by the Editor-in-Chief prior to publication. Final corrections and clarifications occurred during one or more exchanges between the author(s) and copyeditors.