Abstract 19: Implementation of “Flex Time” in a Plastic Surgery Residency Program: Impact on Duty Hours, Case Volume, Research Productivity, and Symptoms of Burnout

Abstract

Background: Finding balance between clinical duties, educational requirements and personal needs can be challenging to residents and potentially lead to burnout. To address this, we instituted a program of protected time, whereby residents are released from clinical duty at noon after each night of home call. Residents may use that time for scholarly activity, complete required non-clinical assignments, or tend to personal needs as per their discretion. We designate this as “Flex Time.” The objective of this study was to examine the impact of adapting Flex Time on resident duty hours, case volume, research productivity, and symptoms of burnout among Plastic Surgery residents. Methods: This is a single-institution retrospective examination of data evaluating residents in our independent Plastic Surgery residency program from 7/1/2017 to 6/30/2019. We evaluated all three residents for each academic year. Flex Time was uniformly implemented on 7/1/2018. Duty hours, case volume, research productivity, and self-reported symptoms of burnout were compared between residents in the pre-Flex and post-Flex Time periods by comparing each of the two consecutive academic years. Symptoms of burnout were evaluated by means of a survey adapted from the Maslach Burnout Inventory (MBI). Results: Between the two time periods, average weekly work hours remained fairly similar with only a 7.7% decrease noted (69.3 to 63.9 hours). Annual average case volumes per resident decreased by 18.6% from 739.3 cases to 602 cases. There was a substantial increase in resident research productivity from one presentation in the first year to three publications, and seven presentations in the second year. Average scores for all three categories of the MBI showed improvement from pre to post-Flex Time as follows: emotional exhaustion (32 to 20), depersonalization (27 to 16), and personal achievement (23.33 to 34.33). Conclusion: Implementation of a designated Flex Time afforded Plastic Surgery residents greater opportunity for self-care and research development while decreasing symptoms of burnout without compromising case volume. The institution of such protected post-call time when indicated may be of great benefit to trainees in their overall academic growth and maintenance of personal well-being.