Impact of work hour restrictions on resident case experience in an obstetrics and gynecology residency program.

Abstract

The purpose of this study was to evaluate senior resident case experience before and after enactment of work hour restrictions. Obstetrics and gynecology experience from 2 postgraduate year 4 classes were evaluated before and after adoption of work hour restrictions. Data were limited to experience obtained during the fourth year of residency. Data were analyzed with the 2-sample t test and Wilcoxon rank sum test, and adjusted for changes in institutional procedural volume. There were significant decreases in resident experience in total abdominal hysterectomy ( P = .018), procedures for genuine stress urinary incontinence ( P = .004), and hysteroscopy ( P = .006). Decreases were seen in resident experience in vaginal birth after cesarean section ( P = .011), primary cesarean section ( P = .31), and vacuum delivery ( P = .007), despite increase in institutional volume. Work hour restrictions have had impact on resident case experience in obstetrics and gynecology. Variance in institutional case numbers account for only some of these changes.