A Time Study of Plastic Surgery Residents

Area of Science:

• Medical Education
• Surgical Training
• Work Hour Analysis

Background:

• Current resident work hour restrictions lack data specific to surgical trainees.
• Plastic surgery residents' daily activities and time allocation remain understudied.
• This study addresses the need for prospective time-motion data in plastic surgery residency.

Purpose of the Study:

• To conduct a prospective time-motion study of plastic surgery (PRS) residents.
• To analyze resident time allocation across direct patient care, indirect care, and didactic activities.
• To evaluate time spent on high versus low education-value activities and assess resident efficiency.

Main Methods:

• Minute-by-minute activity logs were collected by trained research assistants over 10 weeks.
• Observed plastic surgery residents (n=8) from morning meeting until completion of non-call duties.
• Analysis focused on time in direct patient care (DPC), high education-value activities (HEAs), fragmentation, and waiting times.

Main Results:

• Residents worked an average of 64.2 hours/week (excluding call).
• Direct patient care (DPC) comprised 50.7% of work time, with surgery being the largest segment (34.8%).
• High education-value activities (HEAs) constituted the majority of work, with surgery as the leading component; work was highly fragmented (57.7% of activities ≤4 mins), and 10.7% of time was spent waiting.

Conclusions:

• Plastic surgery residents spend significantly more time in DPC compared to medicine trainees.
• High education-value activities, particularly surgery, dominate PRS resident workdays.
• Future residency program changes should be pilot-tested with pre- and post-implementation time studies to assess impact.