Orthopaedic residency applications increase after implementation of 80-hour workweek

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Fig. 1

The changes in applications to orthopaedic surgery before and after the implementation of the 80-hour workweek are shown.

Fig. 2

The changes in applications to primary care (PC) before and after implementation of the 80-hour workweek are shown.