ACGME case minimums across 50 specialties

The ACGME publishes at least one category minimum for 39 of the 50 specialties below. The 50 are 14 residencies and 36 fellowships. The largest residency minimum is 1,150 total index procedures, in Plastic Surgery (Independent) and Plastic Surgery - Integrated.

By Chris, CA-1, anesthesiologyUpdated October 2026

Which residencies require the most logged cases?

ACGME residencies ranked by their largest published case minimum
Residency	Largest minimum	Categories with a number
Plastic Surgery - Integrated	1,150	86 of 118
Plastic Surgery (Independent)	1,150	83 of 115
Interventional Radiology - Independent	1,000 overall	0 of 12
General Surgery	850	39 of 39
Neurological Surgery	800	32 of 32
Vascular Surgery (Integrated)	500	14 of 14
Thoracic Surgery (Integrated)	415	82 of 83
Orthopaedic Surgery	300	27 of 27
Urology	250	34 of 35
Obstetrics and Gynecology	200	15 of 15
Anesthesiology	100	15 of 21
Ophthalmology	86	18 of 18
Otolaryngology - Head and Neck Surgery	40	14 of 18
Interventional Radiology - Integrated	25	11 of 23

Capnolog counts these live for anesthesiology and neurological surgery; other specialties are reference only.

Which fellowships require the most?

ACGME fellowships ranked by their largest published case minimum
Fellowship	Largest minimum	Categories with a number
Pediatric Surgery	800	11 of 11
Thoracic Surgery (Independent)	415	68 of 69
Pediatric Urology	350	24 of 45
Adult Cardiothoracic Anesthesiology	300	13 of 17
Ophthalmic Plastic and Reconstructive Surgery	300	4 of 5
Hand Surgery (Surgery)	250	20 of 20
Neuroendovascular Intervention	250	11 of 11
Surgery of the Hand (Plastic Surgery)	250	20 of 20
Vascular Surgery (Independent)	250	14 of 14
Complex General Surgical Oncology	240	13 of 13
Pediatric Anesthesiology	240	38 of 38
Surgical Critical Care	200	18 of 18
Congenital Cardiac Surgery	150	20 of 36
Urogynecology and Reconstructive Pelvic Surgery	130	30 of 31
Urogynecology and Reconstructive Pelvic Surgery (Urology)	130	30 of 31
Gynecologic Oncology	100	17 of 20
Orthopaedic Sports Medicine	100	8 of 8
Pediatric Cardiac Anesthesiology	100	22 of 25
Regional Anesthesiology and Acute Pain Medicine	100	14 of 19
Reproductive Endocrinology and Infertility	80	11 of 11
Pain Medicine	50	3 of 7
Pediatric Otolaryngology	50	7 of 7
Obstetric Anesthesiology	30	10 of 14
Neurotology	25	10 of 14
Hand Surgery (Orthopaedic Surgery)	20	18 of 18
Musculoskeletal Oncology	20	6 of 6
Adult Reconstructive Orthopaedics	—	0 of 16
Anesthesiology Critical Care Medicine	—	—
Complex Family Planning	—	—
Craniofacial Surgery (Craniofacial Plastic Surgery)	—	—
Foot and Ankle Orthopaedics	—	0 of 18
Maternal-Fetal Medicine	—	—
Orthopaedic Surgery of the Spine	—	0 of 11
Orthopaedic Trauma	—	0 of 16
Pediatric Orthopaedics	—	0 of 12
Vascular and Interventional Radiology	—	—

How are the minimums structured?

20 of the 39 specialties with numbers count every minimum in a single column, and 19 read them across two or more columns.
29 nest some categories inside others, so a case in the smaller row also counts toward the larger one.

11 specialties publish no minimum for any single category:

Where do these numbers come from?

Every figure is computed from ACGME tables read on September 8, 2026, for the 2026-2027 academic year. Capnolog is independent of the ACGME; where a number here differs from the ACGME's own document, the document is right.