WOFAPS 2025 8th World Congress of Pediatric Surgery

Andrea Schmedding ¹, Maria Christina Stefanescu ², Sabine Drossard ³

¹ City Hospital of Brunswick, Pediatric Surgery and Pediatric Urology, Baunschweig, Germany
² Department of Pediatric Surgery, University Medical Center Mainz, Germany
³ Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany.

Purpose
Pediatric surgery is the most diverse surgical specialty in Germany, encompassing general, abdominal, thoracic and plastic surgery, traumatology, urology, and knowledge of neurosurgery and vascular surgery. This study analyzes available structural data to examine how the number of cases and surgical procedures per institution correlates with the number of trainees across different hospital types.

Methods
The model curriculum defined by the German Medical Association lists 21 procedural categories with target case numbers, which were matched to corresponding OPS codes. Annual hospital quality reports from 2012-2022 were used to analyze the structure of training. Based on the reported case numbers, it was calculated how many years the existing trainees would theoretically need to complete their training if procedures were evenly distributed.

Results
On average, data from 83.7 departments per year were included. University departments employed an average of 4.4 full-time trainees, compared to 3.2 in non-university hospitals. Overall case volumes declined from 2012-2022, from 1,294.6 to 1,127.7 cases per year in university departments, and from 1,534.1 to 1,237.2 in non-university institutions.

In none of the observed years was a single department able to fulfill all procedural categories relative to the number of trainees. The average number of completed categories in university hospitals declined from 11.36 in 2012 to 8.23 in 2022; in non-university hospitals, from 11.2 to 8.14. Focusing on the eight basic surgical categories, five university hospitals and two non-university hospitals covered all basic categories in 2012. By 2022, no hospital was able to meet this standard.

Conclusion
Many training institutions currently lack sufficient procedural volume to provide comprehensive training to all residents within the designated timeframe. Extended training durations due to limited surgical exposure represent a major obstacle and reduce the attractiveness of pediatric surgery as a specialty. Cooperations will be neccessary in the furure.