Impact of work-hour restrictions on residents' operative volume on a subspecialty surgical service

BACKGROUND: Whether the 80 hours per week limit on surgical residents' work hours has reduced the number or variety of cases performed by residents is unknown. STUDY DESIGN: We quantified residents' operative experience, by case category, on a pediatric surgical service. The number of senior and junior residents' cases were compared between residents from the year before (n = 47) and after (n = 44) the 80-hour limit. Residents also completed a questionnaire about their operative and educational experience. As an additional dimension of the educational experience, resident participation in clinic was assessed. Student's t-test was used. RESULTS: Total number of cases performed either by senior (before, 1.58 +/- 0.42 versus after, 1.84 +/- 0.82 cases/day) or junior (before, 0.70 +/- 0.21 versus after, 0.71 +/- 0.15) residents has not changed (p = NS). Senior residents' vascular access and endoscopy rate increased; other categories remained stable. Residents' perception of their experience was unchanged. But residents' participation in outpatient clinic was significantly decreased (before, 66.0% +/- 14.7% versus after, 17.0% +/- 19.9% of clinics covered, p < 0.005). CONCLUSIONS: The 80-hour limit has had minimal impact on residents' operative experience, in case number and variety, and residents' perceptions of their educational experience. Residents' reduction in duty hours may have been achieved at the expense of outpatient clinic experiences. (c) 2005 by the American College of Surgeons.