General Surgery Residents Log More Operations but Narrower Experience

Hadhoud AM, Moeen-Ud-Din MB, Kaw A, et al. Are We Narrowing the Scope? 16-year Analysis of General Surgery Resident Operative Experience. J Am Coll Surg. September 2026.

More operations may not mean broader surgical training. Hadhoud et al. examined national trends in general surgery residents’ experience with core and advanced procedures over 16 years.

The investigators analyzed Accreditation Council for Graduate Medical Education operative log reports from academic years 2009–2010 through 2024–2025. Using the 2025 Surgical Council on Resident Education (SCORE) curriculum, they classified 352 procedures across 23 operative domains as core, advanced, or undefined.

The number of graduating residents increased 52%, from 1,040 to 1,577, while mean operative volume, including endoscopy, rose 12%, from 1,090 to 1,223 cases. Core procedures accounted for an average of 74.5% of operative volume, compared with 12.2% for advanced procedures.

Core procedure volume increased by 7.2 cases annually, while advanced volume declined by 0.9 cases annually. Similar patterns appeared among chief and junior residents. Core volume increased in eight of 13 general surgery domains but declined in nine of 10 subspecialty domains.

Between the 2018 and 2025 SCORE curricula, 24 procedures shifted from core to advanced classification; their volumes had already been declining before reclassification.

Operative experience increasingly concentrates on frequently performed core procedures. Targeted training may help preserve breadth and prepare residents for diverse practice settings.