Variability in procedure volume of physical medicine and rehabilitation residents graduating from 2014 to 2021.

ABSTRACT

BACKGROUND: Adequate exposure to commonly performed procedures during physical medicine and rehabilitation (PM&R) residency is an important issue. OBJECTIVE: To assess temporal trends and variabilities in reported procedural volumes, including the number of residents achieving procedure minimum requirements as established by the Accredited Council for Graduate Medical Education (ACGME) PM&R Residency Review Committee. DESIGN: This was a retrospective cohort study of PM&R residents graduating from 2013-2014 to 2020-2021. Descriptive statistics were calculated for tracked procedures and compared over time with analysis of variance (ANOVA) tests. Variability was calculated as the procedure volume difference between the 90th and 10th percentile groups. SETTING: ACGME-accredited PM&R residency training programs. PARTICIPANTS: A total of 3231 PM&R residents graduating from 2014 to 2021. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Reported procedure volume and number of residents achieving minimum requirements. RESULTS: Total procedure volume increased over the study period (436 ± 225 to 523 ± 238, p = .013). The percentage of all procedures that were performed versus observed was stable over the study period (81%-77%, p = .234). Variability in total reported procedure volume remained stable over the study period. The percentage of PM&R residents not achieving minimum requirements ranged from 2% for peripheral joint injections to 22% for ultrasound in the contemporary training period. CONCLUSIONS: The volume of reported procedures has increased along with the number of PM&R residency programs and residents. Variabilities in total reported procedure volume were stable over time, but PM&R residents struggle to obtain minimum requirements for ultrasound procedures.