Resident technical experience in obstetrics and gynecology before and after implementation of work-hour rules

Abstract

Objective: To evaluate resident experience in obstetric and gynecologic procedures after implementation of resident work-hour restrictions.

Methods: Median resident experience in core obstetric and gynecologic procedures in the role of "surgeon" for the 3-year period before the implementation of work-hour restrictions were compared with data from a similar 3-year period starting 4 years after the work-hour rules were in effect. Comparisons to national practice changes occurring over the same time period were made with national data.

Results: Resident experience in core obstetric procedures has changed in parallel with those occurring nationally, but with little overall effect on total experience (3-year average of median total cases, 513 compared with 510) with a decrease in operative vaginal deliveries (42 compared with 26 cases) and an increase in cesarean deliveries (166 compared with 221 cases). Resident experience with abdominal hysterectomy declined (83.7 compared with 75.4 cases), while experience with vaginal hysterectomy remained steady (31.3 compared with 34.6 cases). In contrast, there was an increase in experience with laparotomy (41.7 compared with 54.6 cases), laparoscopy (56.7 compared with 94 cases), and hysteroscopy (39.7 compared with 62.7 cases). Comparisons to national practice changes occurring over the same time period show similar patterns.

Conclusion: The imposition of work-hour restrictions has not had material negative effects on resident technical experience.

Level of evidence: III.