Presentation Authors: Adam Kinnaird*, Logan Zemp, Andrew Rasmussen, Michael Chetner, Keith Rourke, Trevor Schuler, Edmonton, Canada
Introduction: Resident education in Canada is currently undergoing major changes in the way it is administered. As the Canadian population grows, the strain on our health care resources, including workloads of surgeons and surgical residents, increases within our resource-limited, universal healthcare system. Within the last year, multiple high-impact publications suggest that surgical residents express high levels of burnout, depression and suicidal ideation. Therefore, our objective is to assess how resident workload has changed over the last decade to gain insight into potential contributing factors to resident well-being.
Methods: We retrospectively analyzed prospectively collected institutional datasets, managed by expert database managers, to obtain information within the following domains (specific dataset): Urology ward admissions (Tandem), Urology ORs (ORM), Emergency Department consults (EDIS) and Urology service pagers (Citipage). Data was collected for 2007 to 2017, inclusive, and stratified by hospital (University of Alberta Hospital, Royal Alexandra Hospital, Misericordia Hospital and Stollery Children&[prime]s Hospital when available). Spearman&[prime]s rank correlation coefficient was calculated and p < 0.05 considered significant.
Results: Data was available for 2007 to 2017 in all domains except for Urology service pagers due to this data being deleted every 6 months as per confidentiality policy. The number of Urology ward admissions (during a one-year interval) increased by 1192 during the study period with an average percent increase of 46% across sites (p < 0.01 all sites). Similarly, the number of Urology ORs increased by 134 procedures per month during the study period with an average increase of 46% across sites (p < 0.001 all sites except Misericordia, p=0.11). The Urology service received 999 more Emergency Department consults in 2017 compared to 2007 with an average increase of 300% across sites (p < 0.001 all sites except Stollery, p=0.06). The Urology day pagers (which operate from 07:00-17:00 at our tertiary and quaternary care centers) were paged an average of 37 times per day per site.
Conclusions: The Urology service workload has increased across all domains captured in this study. This increased clinical volume may benefit the educational experience of residents while paradoxically also potentially contributing to work-related stress for residents and staff Urologists. These data may be interpreted as an impetus to explore further assistance from allied health professionals such as Physician Assistants and Nurse Practitioners to assist with increased inpatient workload.