title: Preparation for practice in family medicine: before and after duty hours.
abstract: OBJECTIVE
  In July of 2003, the Accreditation Council for Graduate Medical Education (ACGME) adopted requirements limiting the duty hours of resident physicians. The impact of these restrictions on education and patient care activities is not clear. The purpose of this study is to examine the perception of graduates of family medicine residency programs immediately prior to and following implementation of duty hours  regarding preparedness to practice and board certification status, as well as current patient care activities.
  
  
  METHODS
  Surveys of graduates of family medicine residency programs in South Carolina were conducted. Preparation for practice and professional activities of program graduates prior to (1999--2003) and following (2005--2009) implementation of duty hours were compared.
  
  
  RESULTS
  Response rates were 54.4% and 53.1%, respectively. No significant differences by survey years in the average age, gender, or race was noted. Recent graduates felt as well prepared for practice in most curricular areas except surgery (OR=0.50 [0.27, 0.91]) and performed similar procedures with the following exceptions: central line placement (OR=0.32 [0.11, 0.95]), flexible sigmoidoscopy (OR=0.12 [0.02, 0.80]), ICU care (OR=0.39 [0.22, 0.70]), and ventilator management (OR=0.54 [0.29, 0.99]). Higher proportion of recent graduates do not take after hours call (22.3% versus 8.6%). Similarly, fewer recent graduates care for patients in nursing homes (22.0% versus 44.9%) and hospitals (46.2% versus 68.0%).
  
  
  CONCLUSIONS
  Implementation of resident duty hours appears to have little overall association with self-reported preparedness for practice. An association was noted in the patient care services and procedures performed.
authors.affiliation: Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29406, USA. carekpj@musc.edu
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Carek
authors.forename: Vanessa
authors.initials: V
authors.lastname: Diaz
authors.forename: Lori M
authors.initials: LM
authors.lastname: Dickerson
authors.forename: Lars
authors.initials: L
authors.lastname: Peterson
authors.forename: Sharleen
authors.initials: S
authors.lastname: Johnson
mesh_terms: D000068:Accreditation / Q000592:standards*; D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D010465:Perception; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D013022:South Carolina; D016526:Workload / Q000592:standards