Introduction. Balancing efficiency and quality in resident education and clinical care is challenging, particularly in a large tertiary center with resident work hour restrictions. This study investigates the use of daily allocation of surgical residents to operative cases and clinics with the goal of improving patient care, resident education, and coverage. Methods. Surgical residents were allocated to cases and clinic activities a day ahead, with a central email generated and sent to all surgical staff the day prior to the procedures and duties. A ten-item questionnaire was administered to the staff on the surgery service before and after this intervention, evaluating perceptions of educational experience, patient care, and coverage of operative cases, clinic, and floor duty. Results. A total of 28 staff members participated. No significant difference was found in the perception of stress at work, coverage of OR cases, or clinic attendance after the intervention. However, a statistically significant increase ( ) was noted in the perception of resident’s educational experience in the clinic (39% vs. 94%), appropriate case distribution (54% vs. 94%), and quality of patient care (50% vs. 100%). Conclusions. Daily allocation of surgical residents to operative cases and clinic activities improves perceptions of resident educational experience and quality of patient care in a busy clinical setting. 1. Introduction First implemented by Halstead in 1889, the formal surgical residency model revolutionized the training of young surgeons. An important feature of this model was a clear distribution of responsibilities and clinical duties among successive training years, ensuring that students had adequate experience and decision making capacities upon their completion of the training [1]. Over the past century, this model has been refined and standardized across the country, expanding upon the principles of Halstead. However, recent changes in resident work hour regulations, in 2003 limiting hours to 80 per week and in 2011 limiting intern shifts to no more than 16 hours, have sparked controversy over the quality of patient care and resident education within the current residency model [2]. In response to the perceived or realized problems of duty hour reform, program directors have employed a number of strategies to confront these new problems, with varying success. These strategies have included leadership/communication training, increasing access to technology, hiring of fellows and midlevel providers, increasing the number of residents in each year, and
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