Damadi Amir, Davis Alan T, Saxe Andrew, Apelgren Keith
Department of Surgery, Michigan State University College of Human Medicine, Lansing, Michigan 48912, USA.
J Surg Educ. 2007 Sep-Oct;64(5):256-9. doi: 10.1016/j.jsurg.2007.07.008.
We compared the operative experience of chief residents at the Michigan State University Integrated Residency Program in General Surgery before and after duty-hour restrictions mandated by the Accreditation Council for Graduate Medical Education.
Conflicting evidence exists regarding the influence of duty-hour restrictions upon resident operative experience.
Resident self-reported operative experience submitted to the Residency Review Committee (RRC) for Surgery was tabulated. To control for a possible overall decrease in surgical procedures, for example, a decrease in referrals to the institution, the departmental database of surgical billings that is maintained independently from resident operative experience data also was reviewed.
An overall decrease of nearly 20% occurred in resident operative volume after promulgation of duty-hour restrictions. All residents met minimum RRC operative experience requirements. Over the same period, no decrease was found in the number surgical procedures performed by the department.
Our data suggest that restriction of resident duty hours is associated with a significant decrease in operative experience.
我们比较了美国研究生医学教育认证委员会规定的工作时间限制实施前后，密歇根州立大学普通外科综合住院医师培训项目中住院总医师的手术经验。
关于工作时间限制对住院医师手术经验的影响，存在相互矛盾的证据。
将提交给外科学住院医师评审委员会（RRC）的住院医师自我报告的手术经验制成表格。为了控制手术程序可能出现的总体减少，例如转诊至该机构的减少，还审查了独立于住院医师手术经验数据维护的部门手术计费数据库。
工作时间限制颁布后，住院医师的手术量总体下降了近20%。所有住院医师均达到了RRC规定的最低手术经验要求。在同一时期，该部门进行的手术数量没有减少。
我们的数据表明，住院医师工作时间的限制与手术经验的显著减少有关。
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