Resident Operative Experience During the Transition to Work-Hour Reform

Abstract

HYPOTHESIS: The operative volume of chief residents would decrease with work-hour reform by the Accreditation Council for Graduate Medical Education (ACGME). DESIGN: Mixed-design study performed during July and December 2003. Collected data were from programs experimenting with work-hour reform and programs that had not yet implemented reform. New York programs were also included. SETTING: University-, community/university-, and community-based surgical residency programs. OTHER PARTICIPANTS: Telephone conversations occurred with 10 randomly selected program directors. MAIN OUTCOME MEASURES: Operative logs from chief residents graduating in 2002 and 2003 and a survey requesting information on programmatic changes. RESULTS: Of the 80 programs that responded, statistical analyses revealed the following findings: (1) there were no significant differences in the operative volume of chief residents based on work-hour model, program setting, or graduating class; (2) there was no significant difference in chiefs' operative volume between programs that experimented with work-hour reform and programs that did not experiment with work-hour reform during 2002-2003; (3) there was no relationship found between work hours and volume of operative cases; and (4) there was an inverse relationship found between work hours and operative volume for residents in New York programs. CONCLUSION: Several correlates must be considered for effective assessment and evaluation of the impact of work-hour reform on surgical training and education.