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What They Are Really Doing

Karen J. Brasel, MD, MPH; Amy L. Pierre, BA; John A. Weigelt, MD

Arch Surg. 2004;139:490-494.

Hypothesis  We attempted to better quantitate resident work within our system of care.

Design  Survey.

Setting  Academic training program.

Participants  Surgical residents.

Interventions  A work-hour survey was developed defining 5 areas of activity: patient care related to educational objectives, required educational activities, patient care activities unrelated to educational objectives, off-duty educational activity, and off-duty hours.

Main Outcome Measures  Total work hours and noneducational work hours were analyzed by resident level, rotation, and category.

Results  The survey response rate was 52%, covering 110 workweeks. Residents worked 80 hours or less for 57 weeks and more than 80 hours for 53 weeks. The mean number of hours worked was 77. Fewer than one quarter (21.9%) of work hours were unrelated to educational activities. The amount of time spent in noneducational activities was lowest at community hospitals (17%) and similar at the Veterans Affairs (23%) and academic (22%) medical centers. It did not vary by total hours worked, averaging 21% for rotations of more than 80 h/wk and 23% for rotations of 80 h/wk or less.

Conclusions  Residents spend a large amount of time in noneducational activities. Eliminating these activities would bring our rotations into compliance with the 80-hour workweek. It would also generate a large amount of time for educational activities within our training program.

From the Department of Surgery, Medical College of Wisconsin, Milwaukee.

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