title: Evaluation of the impact of resident work hour restrictions on resident outpatient clinical experience.
abstract: OBJECTIVE
  To estimate the effect of work hour restrictions on resident outpatient clinical experience.
  
  
  METHODS
  Schedule templates from academic years 1998-1999 (before work hour restrictions), 2002-2003 (when night float rotation was added in anticipation of work hour restrictions), and 2008-2009 (during work hour restrictions) were compared for outpatient clinic experience before and after work hour restrictions were implemented. Actual clinics on specific rotations and estimated patient encounters per scheduled clinic were considered.
  
  
  RESULTS
  Between academic year (AY) 1998-1999 and AY 2008-2009 there was a generalized downward trend in average outpatient encounters for postgraduate year (PGY)-2, PGY-3 and PGY-4 residents (45%, 34% and 36%, respectively). For obstetrics, gynecology and ambulatory rotations, there was a downward trend in average outpatient encounters for each rotation type (61%, 14% and 63%, respectively). The average number of scheduled clinics per week was slightly decreased when comparing AY 1998-1999 to either AY 2002-2003 or AY 2008-2009.
  
  
  CONCLUSIONS
  Rotation schedules before and after work hour restrictions demonstrated a downward trend in the number of scheduled outpatient encounters. These findings indicate a potential negative impact on preparation for clinical practice.
authors.affiliation: Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Shweta V
authors.initials: SV
authors.lastname: Patel
authors.forename: Rita W
authors.initials: RW
authors.lastname: Driggers
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Zahn
mesh_terms: D002983:Clinical Competence; D004219:District of Columbia; D006176:Gynecology / Q000193:education; D006801:Humans; D007396:Internship and Residency; D008396:Maryland; D009774:Obstetrics / Q000193:education; D010044:Outpatient Clinics, Hospital; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D000078329:Workforce; D016526:Workload / Q000706:statistics & numerical data