Effect of 2011 Accreditation Council for Graduate Medical Education Duty-Hour Regulations on Objective Measures of Surgical Training

Abstract

Objective: In July 2011, new Accreditation Council for Graduate Medical Education duty-hour regulations were implemented in surgical residency programs. We examined whether differences in objective measures of surgical training exist at our institution since implementation.

Design: Retrospective reviews of the American Board of Surgery In-Training Examination performance and surgical case volume were collected for 5 academic years. Data were separated into 2 groups, Period 1: July 2008 through June 2011 and Period 2: July 2011 through June 2013.

Setting: Single-institution study conducted at the Mount Sinai Hospital, New York, NY, a tertiary-care academic center.

Participants: All general surgery residents, levels postgraduate year 1 through 5, from July 2008 through June 2013.

Results: No significant differences in the American Board of Surgery In-Training Examination total correct score or overall test percentile were noted between periods for any levels. Intern case volume increased significantly in Period 2 (90 vs 77, p = 0.036). For chief residents graduating in Period 2, there was a significant increase in total major cases (1062 vs 945, p = 0.002) and total chief cases (305 vs 267, p = 0.02).

Conclusions: The duty-hour regulations did not negatively affect objective measures of surgical training in our program. Compliance with the Accreditation Council for Graduate Medical Education duty-hour regulations correlated with an increase in case volume. Adaptations made by our institution, such as maximizing daytime duty hours and increasing physician extenders, likely contributed to our findings.

Keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; duty-hour restrictions; general surgery/education; internship and residency; patient care; practice-based learning and improvement; surgical training.