Effects of Accreditation Council for Graduate Medical Education Duty Hour Regulations on Clinical Preparedness of First-Year Orthopaedic Attendings: A Survey of Senior Orthopaedic Surgeons

Abstract

It is unclear how the Accreditation Council for Graduate Medical Education (ACGME) resident duty hour restriction has affected attending orthopaedic surgeons in their first year of practice. The purpose of this study was to compare the clinical preparedness of first-year orthopaedic attending surgeons who trained with ACGME duty hour regulations versus those trained without regulations. Senior orthopaedic surgeons with greater than 10 years of experience were surveyed and results indicate that first-year attendings who trained with ACGME duty hour regulations required more supervision reviewing cases preoperatively, required more assistance completing operative cases, had inferior technical skills, had more major operative complications, had poorer physical exam skills, and delivered an inferior quality of care. Private attendings were most critical. In the postregulatory era, residency programs must optimize the resident's time to ensure competency on graduation. Strategies include increasing midlevel staff, focusing on competencies outlined by ACGMEmilestones, and increasing the role of simulation. (Journal of Surgical Orthopaedic Advances 27(1):42-46, 2018).