A paradigm shift in progress: The impact of work hour reform on the operative volume of surgical residents

The purpose of this study was to explore how work hour models impact the operative volume of Chief residents immediately prior to the official transition to national work hour reform.; This study sample comprised all accredited General Surgery programs in the United States. Program Directors were sent a letter inviting participation in this study. Inclusion criteria required the operative data from Chief residents graduating in 2002 and 2003 and completion of a self-designed survey. Fifteen Program Directors were randomly selected to participate in a telephone interview to review these findings.; Of the 80 programs that responded, statistical analyses revealed the following findings: (1) there were no significant differences in the operative volume of Chief residents based on work hour model, program setting, or graduating class; (2) there was no significant difference of Chiefs' operative volume between programs that experimented with work hour reform and programs that did not experiment with work hour reform during 2002–03; (3) there was no relationship found between work hours and volume of operative cases; and (4) there was an inverse relationship found between work hours and operative volume for residents in New York programs.; Continued evaluation of the impact of work hour reform on surgical training and education is necessary. The “I-E-O” model of assessment represents a framework for understanding how the educational and training environment impacts residents and whether these experiences actually contribute to residents' development in this new era of surgical training.