i find this logging of cases more a tedious time-suck than a measure of my surgical success. there are not enough categories to fit the subtleties of what i have learned, and in which cases this has occured.
i can log a case as "surg jr" and feel it was a wasted breast case. and i can do a carotid dissection with the fellow who does the anastamosis when the attending enters the case. and never log it. i have on other occasions done the carotid anastamoses with an attending and logged them, but these partial cases i do not.
or do part of a complex case (i.e. half a BP anastamosis) that never gets logged since the case was an EVAR and i just did 1/2 the bypass part of the surgery for access. obviously i'm on vascular right now, but this happens on every service. i do the gastrotomy closure, bowel resection, and the closure, but don't do the complex biliary anastamosis (long story, repair of endo injury) and again do not log.
i feel these are my most learning cases. and it seems silly that these don't count.
so i hold little faith in these machinations. these measurements. therefore, the number doesn't count. i "have" 200 cases in 2 years. in reality i had 200 cases in my intern year, but i could care less about logging lines, procedures, or partial surgeries.
anyways, just a rant from a tired resident. i understand the need for a log, but it's a very imperfect logging system. which makes me not want to use it.
