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. 2014 Apr;89(4):644-51.
doi: 10.1097/ACM.0000000000000193.

Assessing the effects of the 2003 resident duty hours reform on internal medicine board scores

Jeffrey H Silber  1 , Patrick S Romano, Kamal M F Itani, Amy K Rosen, Dylan Small, Rebecca S Lipner, Charles L Bosk, Yanli Wang, Michael J Halenar, Sophia Korovaichuk, Orit Even-Shoshan, Kevin G Volpp
Affiliations

Assessing the effects of the 2003 resident duty hours reform on internal medicine board scores

Jeffrey H Silber et al. Acad Med. 2014 Apr.

Abstract

Purpose: To determine whether the 2003 Accreditation Council for Graduate Medical Education (ACGME) duty hours reform affected medical knowledge as reflected by written board scores for internal medicine (IM) residents.

Method: The authors conducted a retrospective cohort analysis of postgraduate year 1 (PGY-1) Internal Medicine residents who started training before and after the 2003 duty hour reform using a merged data set of American Board of Internal Medicine (ABIM) Board examination and the National Board of Medical Examiners (NMBE) United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge test scores. Specifically, using four regression models, the authors compared IM residents beginning PGY-1 training in 2000 and completing training unexposed to the 2003 duty hours reform (PGY-1 2000 cohort, n = 5,475) to PGY-1 cohorts starting in 2001 through 2005 (n = 28,008), all with some exposure to the reform.

Results: The mean ABIM board score for the unexposed PGY-1 2000 cohort (n = 5,475) was 491, SD = 85. Adjusting for demographics, program, and USMLE Step 2 exam score, the mean differences (95% CI) in ABIM board scores between the PGY-1 2001, 2002, 2003, 2004 and 2005 cohorts minus the PGY-1 2000 cohort were -5.43 (-7.63, -3.23), -3.44 (-5.65, -1.24), 2.58 (0.36, 4.79), 11.10 (8.88, 13.33) and 11.28 (8.98, 13.58) points respectively. None of these differences exceeded one-fifth of an SD in ABIM board scores.

Conclusions: The duty hours reforms of 2003 did not meaningfully affect medical knowledge as measured by scores on the ABIM board examinations.

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Conflict of interest statement

Other disclosures: None reported.

References

    1. Accreditation Council for Graduate Medical Education. Resident Duty Hours in the Learning and Working Environment. http://www.acgme.org/acgmeweb/Portals/0/PDFs/dh-ComparisonTable2003v2011.... Accessed December 17, 2013.
    1. Accreditation Council for Graduate Medical Education. The ACGME’s Approach to Limit Resident Duty Hours 12 Months After Implementation: A Summary of Achievements, 2004. Report of the Work Group on Resident Duty Hours and the Learning Environment. June 11, 2002. http://www.acgme.org/acgmeweb/Portals/0/PFAssets/PublicationsPapers/dh_d.... Accessed December 6, 2013.
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