title: Impact of work hour restrictions on resident case experience in an obstetrics and gynecology residency program.
abstract: OBJECTIVE
  The purpose of this study was to evaluate senior resident case experience before and after enactment of work hour restrictions.
  
  
  METHODS
  Obstetrics and gynecology experience from 2 postgraduate year 4 classes were evaluated before and after adoption of work hour restrictions. Data were limited to experience obtained during the fourth year of residency. Data were analyzed with the 2-sample t test and Wilcoxon rank sum test, and adjusted for changes in institutional procedural volume.
  
  
  RESULTS
  There were significant decreases in resident experience in total abdominal hysterectomy ( P = .018), procedures for genuine stress urinary incontinence ( P = .004), and hysteroscopy ( P = .006). Decreases were seen in resident experience in vaginal birth after cesarean section ( P = .011), primary cesarean section ( P = .31), and vacuum delivery ( P = .007), despite increase in institutional volume.
  
  
  CONCLUSIONS
  Work hour restrictions have had impact on resident case experience in obstetrics and gynecology. Variance in institutional case numbers account for only some of these changes.
authors.affiliation: Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: May Hsieh
authors.initials: MH
authors.lastname: Blanchard
authors.forename: Saeid B
authors.initials: SB
authors.lastname: Amini
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Frank
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006176:Gynecology / Q000193:education*; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D009774:Obstetrics / Q000193:education*; D009775:Obstetrics and Gynecology Department, Hospital; D009820:Ohio; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D012189:Retrospective Studies; D000078329:Workforce; D016526:Workload