Resident case coverage in the era of the 80-hour workweek

The purpose of our study was to evaluate resident case coverage before and after the implementation of duty-hour restrictions and discuss its potential impact on surgical attendings.

We reviewed cases before (6/2002 to 6/2003) and after (6/2008 to 6/2009) the implementation of duty-hour restrictions, retrospectively.

Academic-affiliated community surgical residency program.

Full-time academic faculty and surgical residents.

Of 5253 cases performed in the year before the 80-hour workweek, 4466 (85%) were covered by residents and 787 (15%) were uncovered. Of the 6123 cases performed after the 80-hour workweek restrictions, 3694 (60%) were covered by residents and 2429 (40%) were uncovered. Despite an increase in operations and faculty, significantly fewer cases were covered by residents when comparing the time-restricted and non-time-restricted periods (85% vs 60%, p < 0.005).

The number of surgical cases without resident participation has increased significantly in the 80-hour workweek. Departments should reevaluate faculty expectations relative to time management, compensation, and nonclinical responsibilities.