Sorry to butt in here… but for the attendings/residents on this forum:
How many cases/week would you consider a high/very high surgical load residency? 20? 40?
Around 10/wk is fine as primary assist. You should have another 10+ weekly cases available where you are second assist with another resident being primary.
I think we have some confusion of cases vs procedures. Austin, Akin, Weil 2nd, arthrodesis 2nd PIPJ = 1
case, 4
procedures.
That answer I gave is
cases, not procedures. 10 cases/wk x 2 years (100wks) of podiatry (24mo pod, then 12mo off service) is 100 weeks on service... so multiply cases per week by 100 weeks. That 10 cases/wk means you graduate with 1000 cases and will be at least 1500-2000+ procedures with first assist level involvement. My grad log numbers were similar to airbud but with a bit more procedures since every damn bunion in Michigan gets an Akin also, lol. That is PLENTY of surgery.... we did higher end programs in terms of logs. I would assume any talk of averaging 15-20+ cases per week includes the second assist ones or is meaning to say procedures instead?
Who knows, but you have to consider what is even possible in a day. When you figure 40hrs per week of potential OR time (less at ASC, more at hospitals... but hospitals are much slower) and consider turnover times and consider some cases going for awhile and driving between facilities (you will drive a lot at 99% of high volume residencies) and also occasional clinic or meal breaks, 30 cases in a week is not really even possible (at least not where I trained). 30
procedures is doable, but consider the difference. If 20+ first assist
cases happened in some weeks or even every week, that is certainly top 1% of all pod residencies in terms of overall volume.
Anyways, it was certainly not possible for me or any resident to get 30 or even 25 first assist F&A cases weekly where I trained since we had a dozen locations, we had limited volume on some days, and first years do the vast majority of the quicker cases like toes or I&Ds and amps while seniors took the recon stuff and trauma. I doubt I ever had a single week with even 20 cases in my whole 3yrs honestly. You don't need more than ~8/wk avg, though... 10 or 12+ weekly cases average and you are golden. You would have to divide the minimum requirements by 100wks to see what you need to "get your numbers," but it is not much at all... and make sure you match a place with at least 2x or 3x the minimums per resident with legit logging. At mine, we might go do a Lapidus/Weil/HT case, then Achilles case, then a Austin/Akin at the surgery center... and then you drive back to the main hospital and just read since by afternoon, there's nothing but I&D add on that you just let the on-call first year do. That would be a 3 case and 6 procedure day first assist... probably better than average day with that particular case complexity. A real busy day might be 5 cases as first assist (maybe 15 procedures if a couple were forefoot slams) and 15+ cases for the week, but you also have those slow months in winter that balance it out also... and you also tend to let your juniors do more and more first assist once you have your numbers and feel fine with certain dissections (at least I did that,,, and make those first years buy you Taco Bell for every Austin skin-to-skin you could've done but let them get!).
You would be surprised at even how many highly regarded programs only have about 5-8 legit first assist cases per resident per week. They still get their numbers, and they learn with very good surgeons and cool cases... but they do a lot of double/triple scrubbing. It is always better to have your cake (numbers) and eat it too (good attendings/teachers). But yeah, I would say 10 per week first assist (so roughly 1000 cases and 1500-2000 procedures) has you above 80% or more of residency programs (not including ones that log fraudulently with unbundling and bogus RRA logs). You are probably ahead of 90% nationwide with those same 10/wk numbers assuming your program does any appreciable amount of
real RRA work (ankle fx, hindfoot fusions, flatfoot, etc... not just hindfoot I&D, partial calcanectomy, de/reattach, and Charcot "recon" that will get a BKA a couple months later). That is something you really have to pay attention to... is the "RRA" real recon stuff and trauma or just a bunch of diabetic nonsense? You want to see and learn it all... the recon stuff is much harder and patient expectations are much higher.