No Correlation Between Work-Hours and Operative Volumes: A Comparison Between United States and Danish Operative Volumes Achieved During Surgical Residency

TY - JOUR

T1 - No Correlation Between Work-Hours and Operative Volumes

T2 - A Comparison Between United States and Danish Operative Volumes Achieved During Surgical Residency

AU - Kjærgaard, Jane

AU - Sillesen, Martin

AU - Beier-Holgersen, Randi

N1 - Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Objective Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week. We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. Design Retrospective comparative study. Participants The data from the US population was extracted from the Accreditation Council for Graduate Medical Education database for General Surgery residents from 2012 to 2013. For Danish residents, a questionnaire with case categories matching the Accreditation Council for Graduate Medical Education categories were sent to all Danish surgeons graduating the national surgical residency program in 2012 or 2013, 54 in total. Results In all, 30 graduated residents (55%) responded to the Danish survey. We found no significant differences in mean total major procedures (1002.4 vs 976.9, p = 0.28) performed during residency training, but comparing average major procedures per year, the US residents achieve significantly more (132.3 vs 195.4, p <0.01). When factoring in differences in time spent in training, this amounts to a weekly average difference of 1.2 cases throughout training. Conclusions In this study, we find no difference in overall surgical volumes between Danes and US residents during their surgical training. When time in training was accounted for, differences between weekly surgical volumes achieved were minor, indicating a lack of direct correlation between weekly work-hours and operative volumes achievable. Factors other than work-hours seem to effect on operative volumes achieved during training.

AB - Objective Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week. We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. Design Retrospective comparative study. Participants The data from the US population was extracted from the Accreditation Council for Graduate Medical Education database for General Surgery residents from 2012 to 2013. For Danish residents, a questionnaire with case categories matching the Accreditation Council for Graduate Medical Education categories were sent to all Danish surgeons graduating the national surgical residency program in 2012 or 2013, 54 in total. Results In all, 30 graduated residents (55%) responded to the Danish survey. We found no significant differences in mean total major procedures (1002.4 vs 976.9, p = 0.28) performed during residency training, but comparing average major procedures per year, the US residents achieve significantly more (132.3 vs 195.4, p <0.01). When factoring in differences in time spent in training, this amounts to a weekly average difference of 1.2 cases throughout training. Conclusions In this study, we find no difference in overall surgical volumes between Danes and US residents during their surgical training. When time in training was accounted for, differences between weekly surgical volumes achieved were minor, indicating a lack of direct correlation between weekly work-hours and operative volumes achievable. Factors other than work-hours seem to effect on operative volumes achieved during training.

KW - Denmark

KW - Female

KW - General Surgery

KW - Humans

KW - Internship and Residency

KW - Male

KW - Personnel Staffing and Scheduling

KW - Retrospective Studies

KW - Surveys and Questionnaires

KW - United States

KW - Work Schedule Tolerance

KW - Workload

KW - Comparative Study

KW - Journal Article

U2 - 10.1016/j.jsurg.2015.11.007

DO - 10.1016/j.jsurg.2015.11.007

M3 - Journal article

C2 - 26708491

SN - 1931-7204

VL - 73

SP - 461

EP - 465

JO - Journal of Surgical Education

JF - Journal of Surgical Education

IS - 3

ER -