Extirpative renal surgery volume in training: different roads to the (same?) destination

Purpose To describe the overall extirpative renal surgery (ERS) training volume reported by PU and PS. Methods Case log data from the Accreditation Council for Graduate Medical Education (ACGME) was examined from 2013–2016 for surgery residents ( S res ), urology residents ( U res ), pediatric surgery fellows (PS fel ) and pediatric urology fellows (PU fel ). Case log information for all levels of participation over all case categories that could potentially offer ERS volume were recorded. Volume was estimated using the mean number of included cases during residency and fellowship and the sum was used to estimate total training volume. Volume between groups was compared using the student’s t test. Results Case logs were included for 4447 residents (4259 S res , 840 U res ) and fellows (188 PS fel , 71 PU fel ). Mean PU volume was 113.1, which was higher than the mean PS volume of 10.3 ( p < 0.001). For PU, more ERS were performed during residency than fellowship ( p < 0.001). For PS the opposite was true ( p < 0.001). When examining fellow training only, PU fel performed more ERS than PS fel (11.7 vs. 7.0 p < 0.001). Conclusion While previous publications note similar short-term outcomes for ERS for malignancy for PU and PS, ERS case volume during training is significantly different. Review of recent ACGME data indicate that PU have more overall experience with ERS, with most gained during residency. Additionally, PU fel performed significantly more ERS than PS fel . Further study into how these training differences affect long-term outcomes is necessary.