Novel method to link surgical trainee performance data to patient outcomes

Am J Surg. 2021 Dec;222(6):1072-1078. doi: 10.1016/j.amjsurg.2021.10.018. Epub 2021 Oct 21.


Background: A significant roadblock in surgical education research has been the inability to compare trainee performance to the outcomes of those surgeons after they enter independent practice. We describe the feasibility of an innovative method to link trainee performance data with patient outcomes.

Methods: We extracted surgeon NPI numbers from Medicare claims data for common general surgery procedures between 2007 and 2017. Next, American Board of Surgery (ABS) trainee performance data was cross-referenced with additional resources to supplement NPI data. The patient and trainee datasets were linked using NPI number and a linkage rate was calculated.

Results: We identified 12,952 unique surgeons in the Medicare file. Medicare surgeons were matched with ABS records by NPI number, with 96.2% (n = 12,460) of surgeons linked successfully.

Conclusions: We demonstrated a novel process to link patient outcomes to trainee performance. This innovation can enable future research investigating the relationship between surgical trainee performance and patient outcomes in independent practice.

Keywords: Graduate medical education; Patient outcomes; Surgical education; Trainee competence.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Clinical Competence* / standards
  • Clinical Competence* / statistics & numerical data
  • Education, Medical, Graduate / standards*
  • Education, Medical, Graduate / statistics & numerical data
  • Educational Measurement
  • Female
  • General Surgery / education*
  • General Surgery / standards
  • General Surgery / statistics & numerical data
  • Humans
  • Information Storage and Retrieval / methods*
  • Male
  • Surgical Procedures, Operative / education
  • Surgical Procedures, Operative / standards
  • Surgical Procedures, Operative / statistics & numerical data
  • Treatment Outcome