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J Surg Educ. 2017 Dec 19. pii: S1931-7204(16)30371-3. doi: 10.1016/j.jsurg.2017.12.001. [Epub ahead of print]

Increased Academic Productivity of Orthopaedic Surgery Residents Following 2011 Duty Hour Reform.

Author information

1
Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island. Electronic address: Joey.johnson12@gmail.com.
2
Drexel University College of Medicine, Philadelphia, Pennsylvania.
3
Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island.
4
Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Lousiana.

Abstract

BACKGROUND:

In 2003 and again in 2011, the Accreditation Council for Graduate Medical Education (ACGME) mandated increasingly stringent resident duty hour restrictions. With less time required at the hospital, residents theoretically have more time for other academic activities, such as research. Our study seeks to examine whether the number of research publications by orthopaedic residents increased following implementation of the 2011 ACGME duty hour restrictions.

DESIGN:

Pubmed was queried using publicly available alumni lists from programs across the United States. The years 2008 to 2011 were included to assess pre-2011 productivity. The years 2012 to 2015 were included in the post 2011 group. Paired t tests were used to assess differences between groups. Statistical significance was set to p < 0.05 a priori.

SETTING:

A total of 10 orthopedic surgery residency programs across the United States.

PARTICIPANTS:

The study group was composed of 5 of the 2015 top 20 National Institutes of Health (NIH) funded programs and 5 programs without NIH funding.

RESULTS:

When corrected for number of residents per year, there were 0.290 publications per resident/year from 2008 to 2011 increasing to 0.528 publications per resident/year from 2012 to 2015 following implementation of the 2011 work hour restrictions (p = 0.033). When corrected for number of residents per year, there remained no difference in publications per resident from 2008 to 2011 (p = 0.81) or from 2012 to 2015 (p = 0.10) between NIH and non-NIH funded programs.

CONCLUSION:

There has been little data to support the theory that resident work hour restrictions have improved education or patient care in any meaningful way. In our study, there was a statistically significant increase in publications after 2011; however, the number of publications between NIH funded and non-NIH funded programs did not differ. Our study is the first to demonstrate that with increasing duty hour restrictions, orthopaedic surgery residents may be using more of their free time to conduct research.

KEYWORDS:

Interpersonal Skills and Communication; Medical Knowledge; Patient Care; Practice Based Learning and Improvement; Professionalism; Systems Based Practice; academic productivity; duty hours; orthopedics

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