COPYRIGHT © 2006 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED The Impact of the Accreditation Council for Graduate Medical Education Work-Hour Regulations on the Surgical Experience of Orthopaedic Surgery Residents

Background: The advent of the eighty-hour workweek regulations generated a great deal of controversy over the po-tential loss of operative experience for general surgery and surgical specialty residents. We believed an investigation to review the operative experience of orthopaedic surgery residents before and after the adoption of the Accreditation Council for Graduate Medical Education duty-hour guidelines would provide important information in this debate. Methods: The total number of surgical Current Procedural Terminology codes logged in the case-log database of the Accreditation Council for Graduate Medical Education by each second through fifth year orthopaedic resident at a sin-gle university-based program was collected from July 1, 2001, to June 30, 2005. Two groups were created from the data obtained. Group I (thirty-nine residents) included surgical codes logged for the two years prior to the implemen-tation of the eighty-hour workweek (July 1, 2003), while Group II (forty residents) included the codes for the following two years. The average number of codes was determined for Group I and Group II. The two groups were then subdi-vided by postgraduate year of training. The average number of surgical codes per training year was calculated. Then the second and third year (junior) resident and fourth and fifth year (senior) resident groups were combined to create two subgroups. The mean number of surgical codes was determined for each group, and the groups were compared. Results: The surgical case logs of thirty-five orthopaedic residents were reviewed during the study period. One resi-dent left the program during the first year of the study and was excluded because of incomplete data. A total o