title: Operative volume in the new era: a comparison of resident operative volume before and after implementation of 80-hour work week restrictions.
abstract: OBJECTIVE
  To determine the effect of the 80-hour work week restrictions on general surgery resident operative volume in a large, community-based, university-affiliated, general surgery residency program.
  
  
  METHODS
  We performed a retrospective review of Accreditation Council for Graduate Medical Education (ACGME) operative logs of general surgery residents graduating from a single residency. The control group consisted of the residents graduating in the 3 years prior to the work-hour restriction implementation (2001, 2002, and 2003). Our comparison group consisted of those residents graduating in the first 2 classes whose entire residency was conducted after the implementation of the 80-hour work week (2008 and 2009). Comparisons were made between the control and the comparison groups in the 19 ACGME defined categories, total number of major cases, total number of chief cases, and total number of teaching assist cases.
  
  
  RESULTS
  Operative volumes in 13 categories (skin/soft tissue/breast, alimentary tract, abdominal, liver, pancreas, vascular, endocrine, pediatrics, endoscopy, laparoscopic-complex, total chief cases, total major cases, and teaching cases) were not significantly affected by the implementation of the 80-hour work week. One of the 19 categories (laparoscopic-basic) showed a significant increase in operative volume (p < 0.0001). In 4 of the 19 categories (head/neck, operative-trauma, thoracic, and plastics), operative volume was significantly decreased in the post-80-hour work week era (p < 0.05). Nonoperative trauma could not be assessed, as the category did not exist before the work-hour restrictions.
  
  
  CONCLUSIONS
  Resident operative volume at our institution's general surgery residency program largely has been unaffected by implementation of the 80-hour work week. Residencies in general surgery can be structured in a manner to allow for compliance with duty-hour regulations while maintaining the required operative volume outlined by the ACGME defined categories.
authors.affiliation: Department of Surgery, The University of Kansas School of Medicine, Wichita, Kansas 67214, USA.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Bruce
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Helmer
authors.forename: Jacqueline S
authors.initials: JS
authors.lastname: Osland
authors.forename: Alex D
authors.initials: AD
authors.lastname: Ammar
mesh_terms: D000046:Academic Medical Centers; D000068:Accreditation / Q000592:standards; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D010561:Personnel Staffing and Scheduling / Q000331:legislation & jurisprudence*; D012189:Retrospective Studies; D012955:Societies, Medical; D013997:Time Factors; D014940:Work Schedule Tolerance; D016526:Workload / Q000592:standards*