Comparative study of the operative experience of surgical residents before and after 80-hour work week restrictions

Purpose: In Korea, the working-hour limitation regulation has been implemented in December 2017. We aimed to define the difference in operative experience of surgical residents before and after implementing this policy in 2 hospitals among 8 affiliated hospitals of the Catholic Medical Center where implemented the 80 working-hour limitation policy since March 2015. Methods: All the operation records were reviewed, and the number of resident-participated surgeries between March and August in 2002 and 2017 were compared. Operations performed or participated in by residents as first assistants were defined as resident participated surgery. Results: After 2 years from the initiation of the resident work-hour limitations, the number of resident participated surgery has slightly decreased in both hospitals (Yeouido St. Mary's Hospital [YSM]: 317 to 302, St. Paul Hospital [SPH]: 635 to 461). For each resident, changes were like followings: $0{\rightarrow}21$ cases for R1, $65{\rightarrow}72$ cases for R2, $83{\rightarrow}192$ cases for R3, and $169{\rightarrow}17$ cases for R4 in YSM. In SPH, number of resident participating surgery was changed like followings: $4{\rightarrow}32$ cases for R1, $222{\rightarrow}100$ cases for R2, $317{\rightarrow}300$ cases for R3, and $92{\rightarrow}29$ cases for R4. In both hospital, while, total number of resident participating oncologic surgery has been decreased, number of resident participating appendectomy has been far increased. Activity of each grade resident is different according to hospital. Conclusion: Although total number of resident participating surgery decreased, variable changes were observed in each grade of resident according to each type of surgery and different hospitals. It is believed that comparisons of experiences from more hospitals in the future would be helpful in establishing the guidelines for surgical experience requirement of residents in Korea.