Since the 2018 Accreditation Council for Graduate Medical Education (ACGME) reduction of core surgical requirements from 24 to 18 months during integrated vascular surgery residency, vascular residents’ operative experience has been unaffected, suggesting improved training optimization and efficiency.
This was the salient conclusion drawn from a recent retrospective analysis led by Emily Y. Fan, MD, a vascular surgery attending and associate program director at the University of Massachusetts Chan School of Medicine, Worchester, Massachusetts, and set to be presented by Dominique M. Dockery, MD, vascular surgery PGY2 resident, during the SVS-VESS Scientific Session 2a (3:15–4 p.m.) today at the 2025 Vascular Annual Meeting (VAM) in New Orleans (June 4–7).
Fan and colleagues’ review of public ACGME case logs compared the five years prior (2013–2017) to the post-reduction period (2018–2022), marking trends in numbers of surgeon chief/junior cases over four categories including: general surgery open, general surgery laparoscopic, vascular surgery open, and vascular surgery endovascular in three anatomic regions: head/neck, thoracic, and abdominal.
“We found that reducing core surgery requirements did not negatively impact overall operative volume or the proportion of general and vascular surgery cases,” said Dockery and Fan, speaking to VS@VAM ahead of today’s session. In the post-reduction period, an average of 260 cases were logged by integrated residents per year—general surgery accounted for between 34–38% of total operative volumes, with an average of 95.3 cases. The research team found no significant changes in operative experience by anatomic region.
The research group also found that general surgery and laparoscopic cases in all three anatomic regions remained stable, while total operative volume, open surgical cases—including open abdominal aortic aneurysm repair—and the proportion of general versus vascular surgery cases also remained unchanged between pre- and post-reduction periods.
“Rather, there were shifts in the types of general surgery cases being done, with trends towards increased open cases and decreased laparoscopic cases,” Dockery explained. “This suggests our trainees are utilizing core surgery time in a more efficient manner.” The results showed a decrease in general surgery laparoscopic averages in the post-reduction era from 49.8 to 44.8 cases, with concomitant minor increases in general surgery open thoracic and open abdominal averages.
In the absence of evidence showing that reduced core surgical requirements for vascular residents negatively impacts training opportunities, Fan and colleagues’ results indicate that working smarter, not harder may be beneficial.
“Trainee education is an integral part of our specialty, and it’s important to continuously assess our training paradigms,” Fan added.
Endorsing further reassessment, the research group hope that an additional reduction in general surgery requirements to 12 months should be considered a feasible option without compromising surgical training quality. “We hope this research will help inform potential future changes in training requirements as we continue to adapt and optimize our training programs,” Fan stated.
