Department of Orthopaedic Surgery, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA.
Clin Orthop Relat Res. 2013 May;471(5):1720-4. doi: 10.1007/s11999-013-2785-1. Epub 2013 Jan 15.
The factors that influence interest among medical students toward different medical specialties with time are important. The potential impact of changes in work-hour rules on orthopaedic applications in comparison to that of primary care medicine has not been reported. The change in number of applicants to general surgery during this period also is unknown.
QUESTIONS/PURPOSES: The goals of our study were to assess the changes in orthopaedic applications relative to the 80-hour workweek and to compare these changes with those in the primary care field. We also documented the change in applications to general surgery after the work-hour changes.
A retrospective analysis of data from the National Resident Matching Program, San Francisco Matching Programs, and the American Urological Association from 1997 to 2010 was performed. Two cohorts of medical school applicants to primary care and surgery were established: those who applied from 1997 to 2002, predating work-hour changes, and those who applied from 2005 to 2010, after implementation of the 80-hour regulation. From the surgical data, applications to orthopaedic and general surgery were subselected and analyzed. Data were analyzed from a total applicant pool of 111,973 representing primary care and surgery applications. There were 59,996 and 51,977 applicants before and after the work-hour changes, respectively.
Applications to orthopaedics increased by 21% (3310 to 4011 applicants) after implementation of work-hour changes, whereas primary care applications decreased by 18% (42,587 to 34,884 applicants) after the work-hour rules. General surgery applications decreased by 24% during this period.
Residency applications to orthopaedic surgery have increased since inception of the 80-hour workweek. By contrast, applications to primary care programs and general surgery have decreased after implementation of work-hour restrictions.
随着时间的推移，影响医学生对不同医学专业兴趣的因素很重要。尚未报道工作时间规则的变化对骨科申请的影响与初级保健医学相比的情况。在此期间，普通外科申请人数的变化也不得而知。
问题/目的：我们研究的目的是评估骨科申请相对于每周 80 小时工作时间的变化，并将这些变化与初级保健领域进行比较。我们还记录了工作时间变化后普通外科申请人数的变化。
对 1997 年至 2010 年期间全国住院医师匹配计划、旧金山匹配计划和美国泌尿协会的数据进行了回顾性分析。确定了两个初级保健和外科医学生申请人群：1997 年至 2002 年申请的人群，即工作时间变化前的人群，以及 2005 年至 2010 年申请的人群，即 80 小时规定实施后的人群。从外科数据中选择并分析了骨科和普通外科的申请。从代表初级保健和外科申请的 111973 名总申请人中进行了数据分析。工作时间变化前后的申请人分别为 59996 人和 51977 人。
工作时间变化实施后，骨科申请增加了 21%（从 3310 人增加到 4011 人），而工作时间规则实施后，初级保健申请减少了 18%（从 42587 人减少到 34884 人）。在此期间，普通外科的申请减少了 24%。
自 80 小时工作周开始以来，骨科住院医师申请人数有所增加。相比之下，工作时间限制实施后，初级保健计划和普通外科的申请人数减少。
