Comparison of Operative Experiences of PGY-1 and PGY-2 General Surgery Residents During Night-Float vs. 24-Hour Call Systems

• Published in: Journal of surgical education 2021-11, Vol.78 (6), p.e56-e61
• Main Authors: Scott, Jillian K., Bhattacharya, Syamal D., Giles, Wesley Heath
• Format: Article
• Language: English
• Subjects: case requirements; duty hours; General Surgery - education; general surgery residency; Humans; Internship and Residency; night-float; Personnel Staffing and Scheduling; Retrospective Studies; Work Schedule Tolerance; work-hours restrictions; Workload
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2021.08.010

We aimed to specifically compare the impact of a night-float system vs. a 24-hour call system on the number and types of cases performed by PGY-1 and PGY-2 general surgery residents to determine if both of these schedules could meet the ACGME first two-year 250 case minimum requirement, and if so, which schedule provided the best operative experience for PGY-1 and PGY-2 residents. This is a retrospective review of call schedules and operative case logs of PGY-1 and PGY-2 general surgery residents. Residents were separated into two groups based on type of call schedule: 24-hour vs. night-float. The case logs of PGY-1 and PGY-2 residents were obtained from the ACGME Case Log System and data analysis was performed between the two groups. This study was performed at a general surgery residency at a hybrid academic center. Forty-three residents met inclusion criteria. Twenty-three were part of the night-float system and 20 were part of the 24-hour call system. Total cases and major cases for PGY-1 and PGY-2 years were compared between the two groups. The 24-hour call group had a significantly higher total number of cases than the night-float group (646.0 ± 181.5 vs. 504.8 ±148.9, p = 0.008). Major cases were also significantly higher in the 24-hour call group than the night-float group (418.5 ± 99.6 vs. 355 ± 99.5, p = 0.043). Both the 24-hour call and night-float systems were able to meet the ACGME first two year 250 case minimum requirement as well as follow work-hour guidelines. The 24-hour call system was associated with PGY-1 and PGY-2 residents having a better operative experience than the night-float system.