See more, do less?-resident-reported training trends in reconstructive urology.

Background: Urologic surgical training has been dramatically affected by numerous practice changes including a significant increase in robotic surgery, rise of subspecialty fellows, and even the coronavirus disease 2019 (COVID-19) pandemic, among others. How resident training has been affected is not well understood. In this study, we aim to describe the changes in resident-reported case log data for reconstructive urology surgeries, specifically for female reconstructive cases.

Methods: Data were obtained from the Accreditation Council for Graduate Medical Education (ACGME) reporting system, which compiles resident-submitted case reports of procedures performed and resident role. Submitted surgeries are categorized by type using Current Procedural Terminology (CPT) codes as well as resident-reported role in the procedure-"surgeon", "assistant", "teaching assistant", or "all roles". Data from graduating urologic residents from 2010 to 2022 were reviewed.

Results: From 2010 to 2022, we observed an increase in "all roles" reconstructive urologic cases logged by residents (0.82 cases per year, P=0.06). Reconstructive cases logged as "surgeon" decreased by 0.77 cases per year (P=0.057), while "assistant" cases increased by 1.48 cases per year (P<0.001). For female reconstructive cases, "surgeon" reported cases declined by 1.1 cases annually (P<0.001) while "assistant" role increased by 0.32 (P<0.001).

Conclusions: Over the last decade, we observed a decrease in resident-reported role as "surgeon" in female reconstructive cases while the overall volume of reconstructive urologic cases simultaneously increased. Understanding these trends is essential for resident educators, while further research is necessary to identify potential causes.