Introduction
Several surgeon-related factors are known to be associated with surgical outcomes. Surgeon years in practice is one of these factors, with some reports suggesting a concave relationship on complex cases, in which outcomes of early-career surgeons improve for the first number of years in practice, stabilize for the middle of their career, and finally decline for very late career surgeons1–3. Such findings may suggest the importance of triaging cases of different complexity to surgeons of different experience levels. However, it remains unknown if the composition of cases in terms of patient risk profile changes with surgeons’ number of years in practice.
There have been very few studies on this topic, however the little evidence that exists in general surgery points to earlier-career surgeons receiving more challenging and higher-risk cases4–6. In cardiac surgery, a prior study showed that surgeons with lower risk-adjusted mortality rates tended to perform CABG surgery on higher risk patients7. Additionally, it has been shown that experienced surgeons with 9-17 years in practice may perform best on highly complex reoperative cases1. However, it is unknown if complex cases are distributed in a way that would optimize patient care in light of this observed trend. The relationship between cardiac surgeon experience and case complexity remains unclear in a field with high risk operations that may warrant further examination.