Evaluating Differences in Case Volume During Orthopedic Surgery Residency by Gender and Race: A Single-Institution Study.

Abstract

Gaining operative proficiency requires adequate case volume during orthopedic residency training. Numerous surgical fields have demonstrated that male residents report higher case volume than female residents. In general surgery, racially/ethnically underrepresented in medicine residents report lower case volume than White residents. We sought to evaluate differences in case volume between male and female orthopedic surgery residents and between White residents and those of other races and ethnicities at a single orthopedic residency. Accreditation Council for Graduate Medical Education case logs were reviewed for orthopedic residents from 2010 to 2023 at a single institution. Overall residency case volume and volume by post-graduate year (PGY) were compared between men and women and between White and "other race" residents. Of 111 residents included, 80.2% self-reported as men, 19.8% as women, 61.3% as White, non-Hispanic, and 32.4% as any other race (for 6.3%, race/ethnicity was unavailable). Overall, women logged a mean of 1865.6 cases while men logged a mean of 1861.0 cases, showing no difference based on gender. At the PGY-4 level, women logged more cases than men, with a mean of 430.3 for women versus 370.0 for men. There was no difference in overall case volume between White residents and those of "other" race/ethnicity, nor were there race/ethnicity-based differences by PGY level. In contrast to prior studies, our retrospective single-institution review found no difference in overall case volume for orthopedic residents based on their self-reported gender or race/ethnicity. Institutions and the specialty at large should continue to create equitable surgical opportunities for orthopedic trainees, while future research should assess autonomy within cases.