The Accreditation Council for Graduate Medical Education (ACGME) implemented mandatory work week hours restrictions in 2003. Due to the traditionally long hours in general surgery, the effect of restrictions on surgical training and case numbers was a matter of concern. Data was compiled retrospectively from ACGME logs and operating room (OR) records at a university hospital for 2002 and 2003. Work week restrictions began in January 2003. This data was reviewed to determine resident case numbers, both in whole and by postgraduate year (PGY). Mean case numbers per resident-month in 2002 were 8.8 ± 8.2 for PGY1s, 16.2 ± 15.7 for PGY2s, 31.4 ± 12.9 for PGY3s, 31.5 ± 17.6 for PGY4s, and 31.5 ± 17.6 for PGY5s. In 2003, they were 8.8 ± 5.2 for PGY1s, 16.6 ± 13.9 for PGY2s, 27.8 ± 12.5 for PGY3s, 38.2 ± 18.8 for PGY4s, and 26.1 ± 9.6 for PGY5s. PGY1s, PGY2s, PGY3s, PGY4s, or all classes were not statistically different. PGY5s did have statistically fewer cases in 2003 (P = 0.03). PGY5s did have statistically fewer cases after the work-hours restriction, which likely represented shifting of postcall afternoon cases to other residents. Comparing other classes and all PGYs, case numbers were not statistically different. Operative training experience does not appear to be hindered by the 80-hour work week.
Get full access to this article
View all access options for this article.
References
1.
BardenC.B., SpechtM.C., McCarterM.D.Effects of limited work hours on surgical training.J Am Coll Surg2002; 195: 531–8.
2.
Committee on Quality of Health Care in America.To Err is Human: Building a Safer Health System.Washington, DC: Institute of Medicine, 1999.
3.
Hopkins TanneJ.United States limits resident physicians to 80 hour working week.BMJ2003; 326: 468.
4.
Work ACGME.Group on Resident Duty Hours. Report of the ACGME Work Group on Resident Duty Hours. Accreditation Council for Graduate Medical Education (ACGME), 2002. Available at www.acgne.org/dutyhours/wkgrapreport611.pdf
5.
GelfandD.V., PodnosY.D., CarmichaelJ.C.Effect of the 80-hour work week on resident burnout.Arch Surg2004; 139: 933–8; discussion 938–40.
6.
WongJ.G., HolmboeE.S., HuotS.J.Teaching and learning in an 80-hour work week: a novel day-float rotation for medical residents.J Gen Intern Med2004; 19: 519–23.
7.
NiedereeM.J., KnudtsonJ.L., ByrnesM.C.A survey of residents and faculty regarding work hour limitations in surgical training programs.Arch Surg2003; 138: 663–9; discussion 669–71.
8.
ChandraR.K.The resident 80-hour work week: how has it affected surgical specialties?Laryngoscope2004; 114: 1394–8; discussion 1319.
9.
BraselK.J., PierreA.L., WeigeltJ.A.Resident work hours: what they are really doing.Arch Surg2004; 139: 490–3; discussion 493–4.
10.
ZareS.M., GalankoJ., BehrnsK.E.Psychological well-being of surgery residents before the 80-hour work week: a multiinsitutional study.J Am Coll Surg2004; 198: 633–40.
11.
WhangE.E., PerezA., ItoH.Work hours reform: perceptions and desires of contemporary surgical residents.J Am Coll Surg2003; 197: 624–30.
