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Since the incorporation of the American Board of Proctology, development and refinement of the process of board certification has been a critical part of the establishment and growth of the specialty of colon and rectal surgery. Continued commitment to the process begun by the early pioneers of this field provides quality practitioners not only when initially trained, but increasingly throughout the continuum of each diplomate's professional career. Board certification and maintenance of certification are the most tangible examples of our commitment to our patients and the public.

Background Several studies have demonstrated increased inhospital mortality following weekend admission. We hypothesized that the presence of resident trainees reduces the weekend mortality trends. Methods We identified all patients with a non-elective hospital admission from 1/1/2003 through 12/31/2008. We abstracted vital status on discharge and calculated the Charlson comorbidity score for all inpatients. We compared odds of inpatient mortality following non-elective admission on a weekend day as compared to a weekday, while considering diagnosis, patient characteristics, comorbidity, hospital factors, and care at hospitals with resident trainees. Results Data were available for 48,253,968 patient discharges during the six-year study period. The relative risk of mortality was 15% higher following weekend admission as compared to weekday admission. After adjusting for diagnosis, age, sex, race, income level, payer, comorbidity, and weekend admission the overall odds of mortality was higher for patients in hospitals with fewer nurses and staff physicians. Mortality following a weekend admission for patients admitted to a hospital with resident trainees was significantly higher (17%) than hospitals with no resident trainees (p