Experience as a surgeon determines resident knowledge

Background. This is a prospective study that compares operative experience with performance on the American Board of Surgery Inservice Training Examination (ABSITE) to establish the primacy of procedural experience in the graduate training environment. Methods. Operative experience was determined from a computerized log of surgical procedures. The Report D of the 1991 ABSITE was used to assign each test item to specific operative procedures and to determine the frequency of the correct response (Fcr) for each item. The fraction of operative procedures (Fs) was determined for each category of surgical procedures (Fs = Number of procedures as surgeon/Total number of procedures). The Fcr was compared to the Fs by use of the Pearson correlation coefficient with significance at 95% confidence. Results. Forty-two residents reported doing 8357 surgical procedures as surgeon in 12 months. Report D contained 209 test items. Of these, 162 items could be assigned to 26 categories of surgical procedures. The Fcr correlated directly with the Fs (p = 0.002, r = 0.605). Conclusions. A significant correlation exists between the experience of surgical residents as surgeon and their performance on the ABSITE.