A National Survey of Motor Vehicle Crashes among General Surgery Residents

Cary Jo R. Schlick, Daniel Brock Hewitt, Christopher M. Quinn, Ryan J. Ellis, Katherine E. Shapiro, Andrew Jones, Karl Y. Bilimoria, Anthony D. Yang

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objectives:Evaluate the frequency of self-reported, post-call hazardous driving events in a national cohort of general surgery residents and determine the associations between duty hour policy violations, psychiatric well-being, and hazardous driving events.Summary of Background Data:MVCs are a leading cause of resident mortality. Extended work shifts and poor psychiatric well-being are risk factors for MVCs, placing general surgery residents at risk.Methods:General surgery residents from US programs were surveyed after the 2017 American Board of Surgery In-Training Examination. Outcomes included self-reported nodding off while driving, near-miss MVCs, and MVCs. Group-adjusted cluster Chi-square and hierarchical regression models with program-level intercepts measured associations between resident- and program-level factors and outcomes.Results:Among 7391 general surgery residents from 260 programs (response rate 99.3%), 34.7% reported nodding off while driving, 26.6% a near-miss MVC, and 5.0% an MVC over the preceding 6 months. More frequent 80-hour rule violations were associated with all hazardous driving events: nodding off while driving {59.8% with ≥5 months with violations vs 27.2% with 0, adjusted odds ratio (AOR) 2.86 [95% confidence interval (CI) 2.21-3.69]}, near-miss MVCs, [53.6% vs 19.2%, AOR 3.28 (95% CI 2.53-4.24)], and MVCs [14.0% vs 3.5%, AOR 2.46 (95% CI 1.65-3.67)]. Similarly, poor psychiatric well-being was associated with all 3 outcomes [eg, 8.0% with poor psychiatric well-being reported MVCs vs 2.6% without, odds ratio 2.55 (95% CI 2.00-3.24)].Conclusions:Hazardous driving events are prevalent among general surgery residents and associated with frequent duty hour violations and poor psychiatric well-being. Greater adherence to duty hour standards and efforts to improve well-being may improve driving safety.

Original languageEnglish (US)
Pages (from-to)1001-1008
Number of pages8
JournalAnnals of surgery
Issue number6
StatePublished - Dec 1 2021


  • Acgme duty-hour policies
  • Emotional well-being
  • General surgery residents
  • Hazardous driving events
  • Motor vehicle crashes

ASJC Scopus subject areas

  • Surgery


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