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Summa Adapts to New Resident Training Rules without Sacrificing Excellence

Jeffrey T. Junko, M.D., Orthopaedic Residency Director, Orthopaedic Focus Winter 2011

Resident training in orthopaedic surgery has undergone momentous changes in recent years. The orthopaedic department at Summa Health System has met the challenges and continues to graduate highly trained physicians who are prepared to excel in their chosen field.

Rapid changes in technology, biologic sciences and diagnostic testing have challenged the ability of teaching programs to keep pace. In addition to meeting the challenges of an ever-expanding wealth of knowledge and treatment techniques, programs have also adjusted to new residency work hour restrictions.

Ten years ago, the Accreditation Council of Graduate Medical Education (ACGME), the federal department in charge of medical residency training, issued the first resident duty hour rules.

The new rules reduced the number of hours a resident physician could work to 80 hours per week. The rules also restricted the number of continuous work hours (hours of work without sleep) to 30 hours.

Prior to these regulations, residents could work 120 hours a week and continuously for upward of 40 hours.  The new regulations were meant to alleviate resident fatigue. It was hoped this would prevent medical errors from occurring. In July 2011, ACGME updated its rules, which now allow for only 24 hours of continuous work and also limited the maximum amount that a first-year resident (an intern) can work to 16 hours.

These rules have improved residents’ well being and have prevented resident fatigue. But the rules have decreased the amount of time a training program has to train the resident.

In light of the rule changes, the orthopaedic residency program at Summa Health System has worked to ensure resident training continues to be progressive, responsive to change and meets the orthopaedic needs of our community.

The program, led by Chair Scott D. Weiner, M.D., has made changes to resident work schedules, call schedules and to the training curriculum in order to maximize resident education.

Dr. Weiner has been fundamental in ensuring that resident education and excellence in patient care are the tenants by which the orthopaedic training program is conducted. Even with the work hour restrictions, the program’s orthopaedic in-training examination scores (a yearly test taken by all orthopaedic residents in the United States) have consistently been above the 90th percentile. This means Summa Health System’s orthopaedic residents score better than 90 percent of all residents tested nationwide.

In addition, Summa Health System residents have maintained a high board passage rate following graduation. By all measures the orthopaedic residents at Summa Health System have continued to excel in the new regulatory environment.

Orthopaedic advances in patient care will continue to occur. It is the goal of the orthopaedic training program at Summa Health System to ensure that our community continues to have access to well-trained physicians who first and foremost care about their patients’ well-being and have the skills and confidence to heal those in need.

By maintaining a top-ranked residency program, Summa Health System will continue to meet all of the orthopaedic needs of our community.