Article Text

  1. C. de Virgilio,
  2. J. K. Tran
  1. Harbor UCLA Medical Center, Torrance, CA


Objective In order to meet the new accreditation requirement set by the ACGME on July 1, 2003, yet still maintain the operative experience of our residents, our program underwent many changes. This included decreasing the number of call nights, eliminating rotations that did not have a heavy operative volume as well as the addition of other rotations that provided for more operative experience. This study examined the impact that the decrease in work hours had on the residents' operative case volume.

Methods The major operative cases of categorical surgical residents (clinical PGY I-V) were recorded from July 1, 2000 to December 31, 2004. The number of call nights each resident took per quarter (defined as a 3-month period beginning July 1) was also recorded during this time period. Residents who were in their research year during this time period were not included in the study. The number of cases per quarter that the residents performed was examined. We also compared the number of cases per resident year as well as number of cases per gender.

Results From July 1, 2000 to December 31, 2004, there was not a significant change in the number of cases performed by categorical surgical residents (p > .4936). The mean number of cases per quarter for successive levels was PGY I: 11, PGY II: 22, PGY III: 87, PGY IV: 63, and PGY V: 45. On analysis, resident year was a predictor in the average number of cases performed, with the greatest number of cases performed in the PGY III year (p < .0001). From July 1, 2000 to December 31, 2001, the PGY I year performed a statistically significant less number of cases than currently. However, since January 2002, the number of procedures has appeared stable. In the remaining PGY II-V years, the number of procedures performed has remained unchanged. Reanalyzing the data disregarding the number of call nights had the same result. The mean number of cases performed by male and female residents was 42 and 41, respectively. There was no difference in the number of major operative cases performed between genders (p = .8188).

Conclusion The 80-hour work week did not make a significant impact on the operative experience of our categorical surgical residents. It is likely that the changes made to the rotational schedule offset the decrease in work hours by increasing the time that the residents spent in the operating room.

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