Resident operative experience during the transition to work-hour reform

The operative volume of chief residents would decrease with work-hour reform by the Accreditation Council for Graduate Medical Education (ACGME).

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.

University-, community/university-, and community-based surgical residency programs.

Telephone conversations occurred with 10 randomly selected program directors.

Operative logs from chief residents graduating in 2002 and 2003 and a survey requesting information on programmatic changes.

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.

Several correlates must be considered for effective assessment and evaluation of the impact of work-hour reform on surgical training and education.