Impact of the 80-hour work week on resident emergency operative experience

Feanny, Mark A.; Scott, Bradford G.; Mattox, Kenneth L.; Hirshberg, Asher

doi:10.1016/j.amjsurg.2005.08.025

« Previous Next »The American Journal of Surgery
Volume 190, Issue 6 , Pages 968-972, December 2005

Impact of the 80-hour work week on resident emergency operative experience

Presented at the 57th Annual Meeting of the Southwestern Surgical Congress, San Antonio, Texas, April 10–12, 2005

Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza #404D, Houston, TX 77030, USA

Received 12 April 2005; received in revised form 8 August 2005

Abstract

Background

The goal of this study was to analyze the impact of the 80-hour work week on the emergency operative experience of surgical residents.

Methods

A 2-year retrospective comparison of the operative experience in emergency abdominal procedures of postgraduate year 4 and 5 residents in a city hospital before (group 1) and after (group 2) duty hour restriction.

Results

There was no difference between groups in the mean number of procedures performed as the primary surgeon, but group 2 showed a 40% decrease in technically advanced procedures with a 44% increase in basic procedures. The study also demonstrated a 54% decrease in the operative volume as first assistant. Operative continuity of care by residents decreased from 60% to 26% of cases.

Conclusions

The ACGME regulatory environment is adversely affecting the emergency operative experience of surgical residents. Our findings underscore the need to develop alternative methods to augment the residents’ operative experience.

Keywords: Residency training , Emergency surgery , 80-hour work week , Laparotomy , Trauma