Rationale/Objective: The competency of surgical trainees is measured by, among other things, summative examinations and operative experience. There is little literature on general surgery training in the Philippines. This study examines the trends in operative case load and variety in training institutions accredited by the Philippine Society of General Surgeons (PSGS) from 2009-2018. Methods: This is an observational cross-sectional study of the surgical outputs of PSGS accredited training institutions as reflected in their annual reports. The study determined the trends in general surgical case load and variety and their distribution across the different training institution types from 2009 to 2018. Results: In the study period, there is a trend to an increasing number of operations across all categories/procedures except for trauma surgeries. Overall, the average number of cases credited to residents meets the requirements set by the PSGS. The distribution of cases, however, is not equal among residents of the different institutiontypes. Changes in scope and differences in interpretation of index operations contributed to significant changes in trends. Conclusion Recommendations include a review of definitions of index operations and strict compliance to changes, the utilization of an annual computerized database and the addition of patient outcome measures in the assessment of resident competencies.