Department of Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio.
Department of Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio.
J Thorac Cardiovasc Surg. 2014 May;147(5):1464-69. doi: 10.1016/j.jtcvs.2014.01.003. Epub 2014 Jan 16.
The American Board of Thoracic Surgery (ABTS) has noted a yearly decrease in the number of examination certificates being awarded, with only 93 certificates awarded in 2011. In 2003, the Accreditation Council for Graduate Medical Education required all programs to implement the 80-hour residency workweek. We hypothesized that this requirement has resulted in trainees being less capable of becoming successfully certified.
We examined the ABTS board scores, both written and oral, from 2000 to 2011. We divided the interval into 2 periods: 2000 to 2005, representing the 6-year, pre-80-hour workweek, and 2006 to 2011, the 6-year period post-80-hour workweek implementation. We analyzed whether a significant difference would be present in the pass rate before and after the 80-hour workweek for both the written and the oral boards.
An inflection point of examination failures was found that started in 2006, correlating with the first examination year the 80-hour workweek would have affected. The written examination failure rates increased from 2006 to 2009 but have since decreased. The actual percentage failing the written component was less than the percentage failing the oral examinations in both periods. The oral examination failure rates have continued to increase at an alarming rate.
An increase has occurred in the failure of the ABTS board examinations that has been significantly greater after implementation of the 80-hour workweek. The failure rate for the written examination was not as significant as that for the oral examination. Because we are now training fewer, and perhaps less successful, cardiothoracic surgeons, it is our duty to develop strategies to improve and promote innovation in the methods of training.
美国胸外科委员会（ABTS）注意到每年颁发的考试证书数量有所减少，2011 年仅颁发了 93 份证书。2003 年，研究生医学教育认证委员会要求所有项目都实施 80 小时住院医师工作周。我们假设这一要求导致受训者在成功获得认证方面的能力降低。
我们检查了 2000 年至 2011 年 ABTS 委员会的笔试和口试成绩。我们将这一期间分为两个阶段：2000 年至 2005 年，代表 80 小时工作周之前的 6 年；2006 年至 2011 年，代表 80 小时工作周实施后的 6 年。我们分析了在 80 小时工作周前后，笔试和口试的通过率是否存在显著差异。
我们发现考试失败率的拐点出现在 2006 年，这与 80 小时工作周首次影响的考试年份相对应。2006 年至 2009 年，笔试失败率上升，但此后有所下降。在两个时期，实际笔试不及格的百分比都低于口试不及格的百分比。口试失败率仍在以惊人的速度持续上升。
ABTS 委员会考试的失败率在实施 80 小时工作周后显著增加。笔试的失败率没有口试那么显著。由于我们现在培训的心胸外科医生数量减少，而且可能不太成功，因此我们有责任制定策略，改进和促进培训方法的创新。
