The robustness of current surgical programs is still a matter of concern in surgery residency applicants . Data from the United States show concerning deficiencies in the operative exposure of general surgery residents . However, no optimal strategy is standardized given the difficulty of objective assessment of technical skill in surgery and the great variation in trainees experience . To ensure consistent quality and educational standards, the use of a logbook registry is increasing among surgical trainee programs ; they constitute a useful tool to increase surgical exposure, reveal weak points of training , and enhance trainee-teacher communication . However, it is still a non-validated proxy of proficiency, and surgical programs don’t have it standardized .
An increasing disquietude in terms of resident operative experience, surgical training hours, and technical proficiency has been described in the literature, revealing direct relation with surgical exposure to common, uncommon, and complex procedures in a regular way during the residency . Our findings suggest a regular number of procedures across the residency duration, among which essential procedures are performed mostly by first-year residents and there is a shift toward complex procedures with increasing residency year, similar to Malangoni et al results, where complex procedures increase through time until the last year of residency training . Conversely, the increased number of subspecialty surgeries lead to a decrease in the quantity of complex procedures such as coloproctology, vascular and thoracic surgery compared to essential procedures led by the general surgeon .
Laparoscopic cholecystectomy (LC) was the most frequent procedure performed by our residents (7404), followed by appendectomy (1604), and hernia repair (1501), which compares to data reported by Malangoni et al and Cortez et al [2, 15]. Drake et al  reported a mean of 110 LC, 50 LA, and 30 laparoscopic groin hernia repairs, like those found in our study (246 LC, 53 LA, and 50 hernia repair). Malangoni et al and Cortez et al described complex procedures such as pancreatic and spleen resections are performed less than 10 times in contrast to 59 Whipple procedures, 10 distal pancreatectomies, and 11 splenectomies performed/assisted by our residents, showing a higher surgical exposure compared to what is reported in the literature [2, 15].
Trauma exposure in general surgery residency remains a complex concern for surgical educators, and program directors in the United States, Canada, and Europe . Trauma training gap in general surgery residency led to the development of various focused courses in the surgical management of trauma, such as the "Advanced trauma operative management" (17). However, the implementation of multiple courses that could improve the confidence and judgment of the surgeon, does not change the fact that trauma education in general surgery residency it's a challenge. Multiple studies try to evaluate the surgical exposure of trauma complex situations and procedures . Frequent trauma related procedures such as laparotomy and thoracotomy are still a matter of concern in different general surgery residency programs during all the surgical training, being performed less than 10 laparotomies and thoracotomies in trauma scenarios by more than 40% of residents, and more than 60% don't perform more than 10 vascular procedures in trauma circumstances . Our results showed a significant trauma-related procedures exposure during all residency training accounting for almost 5 % of all procedures performed including more than 10 laparotomies, thoracotomies, pericardial windows, and each including more than 25 trauma-related thoracostomies performed by young surgeons in their first year as surgery residents. In terms of total trauma-related procedures, Malangoni et al reported a mean of 35 procedures during training lower numbers compared to 591 trauma-related procedures performed by our population which include: thoracic (194), abdominal (138) and vascular (n=33); This data reflects the high trauma volume, and exposure of each resident compared with experience reported in the literature , representing a positive impact in self-confidence in trauma management of general surgeons who graduated from our program.
The operative experience of surgical senior trainees has been published in the United Kingdom and Ireland . Besides that, few studies around the world show the operative experience of each year of residency , and these experiences should be evaluated to analyze the surgical exposure of residents. Lonergan et al  describe their experience using a web-based logbook to analyze the surgical experience of general surgery residents and orthopedics; identifying common surgical procedures, and a gap in surgical training in his own program like the objectives of our logbook, seeking to evaluate the homogeneity of general surgery residents during their training. Residents' perspective of the log-book method as a tracking tool for their surgical exposure was evaluated, showing a 90% of satisfaction, and more than 70% of confidence in surgical experience based on the year of residence, revealing how this method is perceived as a cornerstone in each resident educational process throughout residency training.
Among limitations is the retrospective nature of the study, underreported secondary procedures that could vary the results, and inclusion of only one residency program. Nonetheless, even if only one residency program was included, the number of registered procedures in a 1 year is not insignificant.