title: Does a new surgical residency program increase operating room times?
abstract: BACKGROUND
  Our country faces a shortage of surgeons; hence, we may anticipate the development of new surgery residencies. Therefore, the question of the effect of a new program on operating room times (ORT) is important. Our primary aim was to compare ORT of 3 common procedures done by attendings alone vs ORT of cases with residents.
  
  
  METHODS
  We queried records of 1458 patients from the JFK Medical Center database for laparoscopic cholecystectomy, open inguinal hernia repair, and laparoscopic appendectomy from July 2010 to July 2012. We divided the sample into 2 groups: "attending alone" (2010-2011) and "with residents" (2011-2012). The ORT was calculated by "Cut time" and "Close time," as recorded in the OR. ORT for both groups was calculated using the unpaired t test.
  
  
  RESULTS
  Of the total number of patients, 778 underwent laparoscopic cholecystectomy, 407 underwent open inguinal hernia repair, and 273 underwent laparoscopic appendectomy; of these, 620, 315, and 211 procedures, respectively, were done by the attending alone and 158, 92, and 62, respectively, were done with residents. Differences in ORT for the 3 types of surgery were statistically significant (p < 0.001). There was no statistical significance when comparing the first half with the second half of the academic year for residents' ORT.
  
  
  CONCLUSIONS
  Resident involvement increases ORT. Cost analysis considering OR time and anesthesia time vs federal funding for Graduate Medical Education is complicated. The benefit of new programs in diminishing the shortage of surgeons cannot be underestimated.
authors.affiliation: Department of Surgery, University of Miami, Atlantis, Florida. Electronic address: acastillo5@med.miami.edu.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Castillo
authors.forename: Alberto
authors.initials: A
authors.lastname: Zarak
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kozol
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000379:methods / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000193:education / Q000706:statistics & numerical data; D016208:Databases, Factual; D004503:Education, Medical, Graduate / Q000458:organization & administration; D005260:Female; D013502:General Surgery / Q000193:education* / Q000639:trends; D059685:Herniorrhaphy / Q000193:education / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D007813:Laparotomy / Q000193:education / Q000379:methods; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D009873:Operating Rooms / Q000706:statistics & numerical data*; D061646:Operative Time; D010348:Patient Care Team / Q000458:organization & administration; D015397:Program Evaluation; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: Operating room time; Patient Care; Practice Based Learning and Improvement; Systems-Based Practice; new surgical residency; surgeon shortage