Operative Work Loads in One Hospital's General Surgical Residency Program

Residents training in medical specialties represent an expanding, expensive and largely unstudied pool of medical manpower. This study applies quantification technics to the operative work loads of 41 general surgical residents in a university-affiliated municipal hospital. Operative work loads of 0.7 to 3.0 hernia equivalents per week and mean operative complexities of 1.04 to 1.63 hernia equivalents over the first four years of training suggest underutilization of operative and possibly nonoperative skills. Chief residents performed 8.2 hernia equivalents per week, almost equal to the work loads of all other residents combined. In the aggregate, the residents performed surgery 21 per cent more complex than a population of 19 general surgeons practicing in a neighboring community. The results suggest that efficiencies may be gained through a diminution in the number of residents and in the duration of training, and through more effective tailoring of training to the job to be done in practice. (N Engl J Med 289:660–666, 1973).