Carlin Arthur M, Gasevic Enej, Shepard Alexander D
Department of Surgery, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI 48202, United States.
Am J Surg. 2007 Mar;193(3):326-9; discussion 329-30. doi: 10.1016/j.amjsurg.2006.09.014.
The goal of this study was to determine the effect of the 80-hour work week on resident operative experience.
General surgery resident operative experience was evaluated during a 4-year period and divided into 2 groups: before (group A [July 1, 2001, to June 30, 2003]) and after (group B July 1, 2003, to June 30, 2005]) implementation of the Accreditation Council for Graduate Medical Education duty hour guidelines.
There was a significant decrease in mean total and primary surgeon cases in group B for postgraduate year (PGY) levels 1, 2, and 4 (P < or = .001). There was a significant decrease in PGY 5 teaching assistant and PGY 1 first assistant experience in group B (P < or = .001). There was no difference in PGY 3 resident operative volume.
The mandated work-hour guidelines have negatively impacted the operative experience of general surgery residents, especially at the junior level. Despite implementing modifications designed to optimize resident operative experience, surgical training programs may require further adaptations.
本研究的目的是确定每周80小时工作制对住院医师手术经验的影响。
在4年期间评估普通外科住院医师的手术经验，并将其分为2组：医学研究生教育认证委员会工作时间指南实施前（A组[2001年7月1日至2003年6月30日]）和实施后（B组[2003年7月1日至2005年6月30日]）。
B组中，第1、2和4年住院医师（PGY）的平均总手术例数和主刀手术例数显著减少（P≤0.001）。B组中，第5年住院医师的带教经验和第1年住院医师的第一助手经验显著减少（P≤0.001）。第3年住院医师的手术量没有差异。
规定的工作时间指南对普通外科住院医师的手术经验产生了负面影响，尤其是初级住院医师。尽管实施了旨在优化住院医师手术经验的调整措施，但外科培训项目可能仍需要进一步调整。
