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J Hand Microsurg 2022; 14(02): 132-137
DOI: 10.1055/s-0040-1713066
Original Article

Residency Training and Hand Surgery Practice Patterns: A National Surgical Quality Improvement Program Database Analysis

James J. Drinane
1   Department of Surgery, The Division of Plastic Surgery, Albany Medical Center, Albany, New York, United States
,
Brian Drolet
2   The Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Ashit Patel
1   Department of Surgery, The Division of Plastic Surgery, Albany Medical Center, Albany, New York, United States
,
Joseph A. Ricci
2   The Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
› Author Affiliations Funding None.
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Abstract

Introduction Fellowship-trained hand surgeons may have residency training in either orthopedic, plastic, or general surgery, generating significant variability in education background. To study the effect of different training backgrounds on practice pattern variations, we utilized the NSQIP (National Surgical Quality Improvement Database) database to assess hand surgery volumes and case variety by specialty.

Materials and Methods NSQIP years 2008 to 2017 was queried with hand surgery current procedural terminology codes defined by the American Board of Orthopedic Surgery. Procedures were grouped according to type and specialty, and relative rates calculated. Hand society membership data were used to determine if procedural volume for each specialty in each category and overall contribution to the volume of hand surgery performed nationally was distributed in accordance with membership data.

Results A total of 145,015 hand surgeries were performed; 13,267 (9.1%) by general surgeons, 28,402 (19.6%) by plastic surgeons, and 103,346 (71.3%) by orthopedic surgeons. Orthopedic surgeons performed significantly more bone, fracture, joint, and tendon cases. General surgeons and plastic surgeons performed higher than expected numbers of soft tissue coverage and cases overall with respective excesses of 183 and 22%.

Conclusion Hand surgery is an available fellowship pathway from multiple residencies. Fellowship training does not level the field of real-world practice patterns. Residency training experiences significantly impact practice.

Keywords

hand surgery fellowship - National Surgical Quality Improvement Program - practice patterns - residency training


Publication History

Article published online:
01 June 2020

© 2020. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

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