Plastic Surgery Research Council
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Presenter: Brian C Drolet, MD
Co-Authors: Prsic A; Schmidt ST
Brown University and Rhode Island Hospital

Background: The Accreditation Council for Graduate Medical Education (ACGME) implemented new rules for resident duty hours and supervision in July 2011. However, no revisions were made to the few existing regulations regarding home call. We sought to assess plastic surgery trainees opinions and experiences with home call as well as the perceived effect of home call on patient care, resident education and quality of life.

Methods: Residents and fellows (trainees) in ACGME-accredited Plastic and Reconstructive Surgery (PRS) programs were eligible to participate in this study. After approval by the institutional review board, program coordinators at all PRS training programs in the United States were asked to distribute an anonymous, electronic survey to all trainees in their programs.

Results: 41 programs agreed to participate (367 trainees) and 206 responses were obtained (56.1%). Although all trainees reported that they are required to follow ACGME regulations and 93.4% reported familiarity with home call rules, only 29.5% report they are always compliant.(Fig 1) The most commonly reported violation is working more than 24 consecutive hours (65.1%), and operative clinical care is the most common reason (62.9%) for violation. Most trainees (59.0%) feel that home call regulations are vague but that ACGME regulation (46.8%) and program oversight (57.6%) are adequate. The large majority feel that their program could not function without home call (88.9%).(Fig 2) Finally, most trainees (68.4%) report adequate time for rest and that home call has a positive impact on resident quality of life (58.9%) and education (51.2%). (Fig 3)

Discussion: This is the first study looking at PRS trainees perspectives of home call. Although many trainees (66.9%) feel that home call is a loophole for avoiding more strict ACGME rules, they overwhelmingly (89.1%) support home call over in-house call. PRS trainees report home call as a generally positive experience, and likely would not support further regulation of home call in the fashion of in-house call.

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