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Invited Commentary
September 2013

Chief Resident Operative Experience: A Moving Target

Author Affiliations
  • 1Department of Surgery, Oregon Health and Science University, Portland, Oregon
JAMA Surg. 2013;148(9):847-848. doi:10.1001/jamasurg.2013.2929

The effect of Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions on surgical resident operative experience has been an appropriate concern of residents, faculty, program directors, and such bodies as the Residency Review Committee (RRC) and the American Board of Surgery (ABS). Several studies have already been published on this subject looking at individual program data, as well as national numbers, with varying findings.1-4 This study by Drake et al5 examined national data from the ACGME case log system to look at the volume of chief resident cases and total major cases, as well as case mix, over a 23-year period that encompasses the time before, during, and after work-hour restrictions were implemented by the ACGME in 2003. The authors looked at annual data but then also divided the annual data into 4- to 5-year periods, with a transition period from 2003-2007 during which chief residents’ experience was increasingly affected by work-hour restrictions.