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Has the 80-Hour Work Week Improved Surgical Resident Education?
Erica Sneider, Anne C. Larkin, Jeannine St. Pierre, Shimul A Shah
University of Massachusetts Medical School, Worcester, MA
Objective: To evaluate the effect of the 80-hour work week restriction on resident education within surgical programs in the New England area. DESIGN: Web-based survey.
Setting: All ACGME accredited surgical residency programs in New England (n=20). PARTICIPANTS: Program directors / coordinators in each surgical residency program in New England.
Main Outcome Measures: 1.) Objective analysis with ABSITE scores and ABS exam passing rate, 2.) Subjective analysis of perceptions and curriculum used in surgical education.
Results: 85% (17/20) of surgical programs in New England responded to the survey. Programs began implementing the 80-hour work week from 2002-2004. There was an equal distribution of community (n=8) and academic programs (n=9). Prior to the initiation of the 80-hour work week, residency programs emphasized weekly didactic sessions given by attending physicians (88%), mock orals (88%), and conventional journal club (76%). After the 80-hour work week was implemented, the education curriculum most often consisted of didactic sessions by attendings (100%), mock orals (88%), and simulation labs (75%; p=0.04). There was no difference in ABSITE scores and first time pass rates of the ABS exam before or after the introduction of the 80-hour work week (20% response). Only 25% of programs felt that surgical education was improved after the implementation of the 80-hour work week while 31% felt education was worse. 44% of respondents believed that there was no difference in surgical education.
Conclusions: Despite the positive effects the 80-hour work week has had on resident quality of life and patient care, it does not appear that there have been significant improvements or detrimental effects on surgical education within residency programs in New England.
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