Impact of duty hours and vacation status on resident ABSITE performance

Purpose The American Board of Surgery In-Training Exam (ABSITE) is administered yearly in January, and is used by training programs to gauge trainee progress, inform resident readiness for promotion, and signal resident competitiveness for subspecialty fellowships. We sought to explore the impact of vacation status and duty hours on ABSITE performance, hypothesizing that vacation periods in December or January preceding an ABSITE administration would correlate with better performance, and that higher duty hours would correlate with worse performance. Methods Retrospective de-identified data were collected from ABSITE administrations between 2010 and 2021, with a total of 300 scores from 83 residents at our institution. Variables collected included logged December and January duty hours and vacation status, rotations, PGY, and individual ABSITE percentage and percentile scores. Analysis was performed using Mann–Whitney U test and a mixed-effects regression model. Results We found a significant difference in the distribution of ABSITE percentage scores between residents who worked fewer than 250 h (71.9%) versus more than 300 h (70.5%) ( p < 0.05) in December. In the mixed-effects regression model, only a vacation period in December was found to be a significant positive predictor on ABSITE percentage scores ( F = 4.21, p < 0.05). Conclusions These findings differ from previous studies in that performance differences among residents who had a January vacation prior to ABSITE were not identified. Differences in scores were found between work-hour subgroups for December, and December vacation status was a significant positive predictor of percentage scores. We recommend that duty hours and vacation status during December be considered in the creation of resident schedules and for ABSITE remediation programs.