A National Survey of Motor Vehicle Crashes Among General Surgery Residents

• Published in: Annals of surgery Vol. 274; no. 6; p. 1001
• Main Authors: Schlick, Cary Jo R, Hewitt, Daniel Brock, Quinn, Christopher M, Ellis, Ryan J, Shapiro, Katherine E, Jones, Andrew, Bilimoria, Karl Y, Yang, Anthony D
• Format: Journal Article
• Language: English
• Published: United States 01.12.2021
• Subjects: Accidents, Traffic - statistics & numerical data; Adult; Education, Medical, Graduate; Female; General Surgery - education; Humans; Internship and Residency; Male; Personnel Staffing and Scheduling; Surveys and Questionnaires; United States - epidemiology; Work Schedule Tolerance; Workload; United States
• ISSN: 1528-1140
• DOI: 10.1097/SLA.0000000000003729

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. 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. 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. 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)]. 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.