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Does a new surgical residency program increase operating room times?

Alvaro Castillo1, Alberto Zarak, Robert A Kozol

  • 1Department of Surgery, University of Miami, Atlantis, Florida.

Journal of Surgical Education
|November 12, 2013
PubMed
Summary
This summary is machine-generated.

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Resident involvement in surgery significantly increases operating room times (ORT) for common procedures. This finding is crucial for evaluating new surgical residency programs and their impact on healthcare efficiency.

Area of Science:

  • Surgical Education
  • Healthcare Operations Management
  • Medical Economics

Background:

  • A national surgeon shortage necessitates the development of new surgical residency programs.
  • Understanding the impact of residents on operating room times (ORT) is critical for program planning.

Purpose of the Study:

  • To compare ORT for common surgical procedures performed by attending surgeons alone versus those performed with resident involvement.
  • To assess the efficiency implications of integrating residents into surgical workflows.

Main Methods:

  • Retrospective analysis of 1458 patient records from JFK Medical Center (July 2010-July 2012).
  • Procedures included: laparoscopic cholecystectomy, open inguinal hernia repair, and laparoscopic appendectomy.
  • ORT measured by 'Cut time' and 'Close time'; data analyzed using unpaired t-test.
Keywords:
Operating room timePatient CarePractice Based Learning and ImprovementSystems-Based Practicenew surgical residencysurgeon shortage

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Main Results:

  • Resident involvement was associated with statistically significant increases in ORT for all three procedures (p < 0.001).
  • No significant difference in resident ORT was observed between the first and second halves of the academic year.
  • Specific procedure counts: 620 cholecystectomies, 315 hernia repairs, and 211 appendectomies by attending alone; 158, 92, and 62 respectively with residents.

Conclusions:

  • Surgical resident participation leads to longer operating room times.
  • The cost-effectiveness of new residency programs requires complex analysis, balancing ORT and anesthesia time against Graduate Medical Education funding.
  • The long-term benefit of residency programs in addressing surgeon shortages remains significant.