Poster3 - 02: WORK HOUR RESTRICTIONS DID NOT IMPROVE ACADEMIC PERFORMANCE OF FIRST YEAR RESIDENTS IN A UNIVERSITY SURGICAL RESIDENCY PROGRAM
Thomas N Hawken, MD, Molly A Brittain, MEd, Jessica R Burgess, MD; EVMS
Background: In 2003, the American Council for Graduate Medical Education (ACGME) prohibited residents from working more than 80 hours a week. In 2011, the next step in work hour restrictions (WHR) was implemented by the ACGME when they limited first-year residents from working greater than 16 hours without a break. Safety was the chief concern of the ACGME, citing the danger of over-worked doctors. Lively debate in the surgical educational community ensued. While many argued WHR would ultimately hurt surgical graduate medical education, there was little data to support or refute this claim.
Methods: We sought to study the effect of the 2011 work hour restrictions (WHR) on our residents’ performance on the American Board of Surgery In-Service Training Exam (ABSITE) along with their performance on United States Medical Licensing Examinations (USMLE). We hypothesized that implementation of WHR would have no effect on ABSITE scores. We focused on post-graduate year (PGY) one residents, as these residents are subjected to the greatest amount of restrictions under ACGME’s WHR. Information was deidentified to remove bias. The scores of each resident class from 2000 to 2010 were compared to the classes from 2011-2017. We used a student’s T-test to determine if there was a statistically measurable effect of WHR on academic performance between these two groups.
Results: We found no change in first-year residents’ ABSITE performance before and after WHR (average percent correct 64 vs 65, p=0.72; average percentile 52 vs 46 p=0.19). Over the same time frame, our resident’s performance on USMLE testing improved greatly (Step 1 score 219 vs 231, p=0.0006; step 2 score 222 vs 244, p=0.0001).
Discussion: WHR did not improve our residents’ academic performance. While we cannot say that WHR hindered our first-year residents’ academic performance, it is disconcerting that the improvement in USMLE scores did not translate into improved ABSITE performance. Going forward it would be helpful to study the effect of WHR on other facets of graduate surgical education.