Effect of the 80-Hour Work Week on Cases Performed by General Surgery Residents

Abstract

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.