Surgical residents’ operative experience: Impact of the 80-hour work week

Abstract

Abstract Introduction: Since July 1, 2003 an 80-hour weekly limit to surgical residents' work hours has been enforced by the ACGME. It is not known whether this limit will reduce residents' operative experience. Methods: Quantity and quality of all residents' operative experience rotating on a busy surgical service was examined. Cases in which residents participated were categorized as either minor, major open, minimally invasive, or lines/endoscopy. Residents' average number of cases per day were compared by level of training (senior on the service, PGY-3 or above, and juniors, PGY-1 and 2) in each subcategory, comparing residents on service before (n = 47, twelve consecutive months) and after (n = 33, eight months) implementation of the 80-hour limit. Analysis utilized a two-tailed Student's t test. Results: No significant change in overall number of cases was found for either senior (before, 1.6 +/− 0.4 versus after, 2.0 +/− 0.7 cases/day, P=ns) or junior residents (0.7 +/− 0.2 cases/day both before and after). Juniors' experience did not change in any case category, and neither did seniors', except in lines/endoscopy (before, 0.4 +/− 0.2 versus after, 0.9 +/− 0.4 cases/day, P Conclusions: Within the first eight months since implementation of the work-hour limit, residents' surgical experience has remained essentially equivalent, both in number of cases and in case variety. Further long-term studies are needed, however, to fully assess the impact of the new regulations on surgical education.