Mind the Gap: A Nationwide Analysis of Case Distribution, Resident Exposure and Institutional Variation in German Pediatric Surgery Training

: Even though there are sufficient pediatric surgical procedures in Germany, they are unevenly distributed between hospitals. Under a simplified allocation model, many pediatric surgical departments in Germany currently lack sufficient procedural volume to meet training requirements in the defined training timeframe for all trainees. Structural reforms-including mandatory national documentation, minor MWBO adjustments and the creation of training networks-are necessary to ensure comprehensive and equitable pediatric surgical education. Without these changes, extended training durations and reduced trainee satisfaction may contribute to workforce shortages and limit the future quality of pediatric surgical care in Germany.