title: The 80-hour work week: will we have less-experienced graduating surgeons?
abstract: OBJECTIVE
  Our primary concern when modifying the Mount Carmel Medical Center surgical residency to comply with the "80-hour work week" was the effect on operative experience. Our goal was to measure the impact that work-hour restrictions have on operative volumes and to evaluate the potential benefit of a night rotation to minimize the number of "lost operations."
  
  
  METHODS
  Categorical surgical residents (PGY I-IV) recorded missed surgical procedures on post-call days from September 1, 2002 to March 31, 2004. The data collection is split between the pre-night rotation (September 1, 2002 to March 31, 2003) and post-night rotation (April 1, 2003 to March 31, 2004) periods. The post-night rotation period is further divided to account for the end of the academic year. Previous graduate operative logs were reviewed for comparison.
  
  
  METHODS
  Mount Carmel Health System is a tertiary referral, community-based hospital in Columbus, Ohio.
  
  
  METHODS
  Categorical general surgery residents (Postgraduate Years I to V).
  
  
  RESULTS
  In the 7-month period, extending from September 1, 2002 to March 31, 2003, the average number of missed cases for successive levels was PGY I: 21, PGY II: 31, PGY III: 26, and PGY IV: 40. From April 1, 2003 to June 30, 2003, the average number of missed cases for successive levels was PGY I: 3, PGY II: 7, PGY III: 5, and PGY IV: 6. From July 1, 2003 to March 31, 2004, the average number of missed cases for successive levels was PGY I: 34, PGY II: 8, PGY III: 14, and PGY IV: 30. Before the implementation of a night rotation, residents were projected to miss an average of 202 operations over 4 years. After implementation of a night rotation, the projected loss would drop to 107 operations over 4 years.
  
  
  CONCLUSIONS
  Work-hour restrictions result in a significant decrease in operative experience. This detriment can be partially alleviated with the institution of a night rotation to better regulate in-house call.
authors.affiliation: Department of Surgery, Mount Carmel Health System, 793 West State Street, MSB 3rd Floor, Columbus, OH 43222, USA. benjamin_jarman@yahoo.com
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Jarman
authors.forename: Marcus R
authors.initials: MR
authors.lastname: Miller
authors.forename: R Shane
authors.initials: RS
authors.lastname: Brown
authors.forename: Scott B
authors.initials: SB
authors.lastname: Armen
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Bozaan
authors.forename: George T
authors.initials: GT
authors.lastname: Ho
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Hartranft
mesh_terms: D000068:Accreditation; D002983:Clinical Competence; D003625:Data Collection; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D014940:Work Schedule Tolerance; D016526:Workload