Effect of the 80-hour work week on resident case coverage

J Am Coll Surg. 2008 May;206(5):798-800; discussion 801-3. doi: 10.1016/j.jamcollsurg.2007.12.028. Epub 2008 Mar 24.


Background: On July 1, 2003, residency training programs were required to institute restricted duty hours as mandated by the Accreditation Council for Graduate Medical Education. A major concern, voiced by both surgical residents and faculty, was an expectation that this would result in a decrease in operative experience. We hypothesized that implementing restricted duty hours would decrease case coverage by resident trainees.

Study design: A retrospective study was performed of operative and endoscopic cases scheduled for a single general surgery practice for a year before and after July 1, 2003. Data collected included operation performed, number of attending surgeons present, whether a resident was present, and level of resident.

Results: From July 2002 to June 2003, there were 1,278 cases scheduled; 890 records were available. From July 2004 to June 2005, there were 1,182 cases scheduled; 960 records were available. Before institution of the restricted duty hours, 24.6% of junior-level (PGY1 and 2) cases, 21.7% of intermediate-level (PGY3) cases, and 6.2% of senior-level (PGY4 and 5) cases were not covered by residents. After restricted duty hours were implemented, 27.3% of junior-level cases, 15.9% of intermediate-level cases, and 8.1% of senior-level cases were not covered by residents. Overall 20.8% (185 of 890) and 20.4% (196 of 960) of cases were not covered by residents before and after instituting restricted duty hours, respectively. No difference in case coverage was statistically significant in each category or overall.

Conclusions: Restricted duty hours have not affected resident case coverage.

MeSH terms

  • Education, Medical, Graduate / organization & administration*
  • Endoscopy / statistics & numerical data
  • General Surgery / education*
  • General Surgery / organization & administration
  • Humans
  • Internship and Residency
  • Patient Care*
  • Personnel Staffing and Scheduling / organization & administration*
  • Retrospective Studies
  • Surgical Procedures, Operative / statistics & numerical data*
  • Time Factors
  • United States
  • Workload