Delphi Panel Proposes Updated Anesthesiology Residency Case Log Minimums

Anesthesiology residency case log minimums have not undergone major revision in approximately two decades. A study published in Anesthesiology used a three-round modified Delphi process to develop recommendations ahead of anticipated Accreditation Council for Graduate Medical Education (ACGME) revisions in 2027. The nationally representative panel included 60 residency program directors and academic and private practice anesthesiologists. Participants assessed technical skills, surgical case characteristics, and patient demographics, with consensus defined as at least two-thirds agreement.

All 60 experts completed all rounds. Proposed new minimums included 40 arterial lines, 20 central lines, 10 fiberoptic intubations, 10 one-lung ventilation cases, 10 neuromonitoring cases, and 20 non–operating room anesthesia cases. For point-of-care ultrasound, the panel recommended 10 cardiac and 10 lung examinations. It also recommended increasing peripheral nerve blocks from 40 to 60, adding anatomic specificity requirements, and increasing cardiac cases from 20 to 25.

The panel agreed on definitions for life-threatening pathologies to standardize reporting but did not reach consensus in several areas, including whether to maintain a minimum for patients younger than 3 months. These recommendations may help update training exposure requirements, but they represent expert consensus rather than evidence that the proposed thresholds improve competence or patient outcomes. They do not constitute adopted ACGME requirements.