The Burrill Report

Nearly half of surgical residents believe that work-time restrictions that limit their schedules to no more than 80 hours a week are a “significant barrier” to their surgical education. And according to the survey published in the Journal of the American College of Surgeons, some 43 percent say they want the flexibility to work longer hours than the duty hour regulations allow.

The implementation of the regulations in 2003 was intended to address resident fatigue and improve patient safety, say researchers at the University of Rochester. Before then, residents often worked 100 hours or more weekly. Studies have shown that residents are getting more sleep and their personal lives are improved. But the effect of the regulations on caseload, academic performance, and board examination performance is still poorly understood, researchers say. What’s more, there is evidence to suggest that there has been an increase in communication errors as a result of frequent patient handoffs, they add.

"We were surprised to find that nearly half of surgical residents believe work-hour restrictions are actually an impediment to their training," says Jacob Moalem of the Department of Surgery, University of Rochester Medical Center. "Our current system limits educational opportunities for surgeons who are expressing a desire and a need to learn more in a compact time frame. Senior surgery residents should be given the chance to control their own schedules as they continue to refine their technical skills and transition into independent practice."

The researchers distributed an Internet-based survey to all resident and associate members of the American College of Surgeons. Of 599 respondents, 41 percent believed that regulations were a considerable or moderate barrier to their education. Less than one-third of residents reported that their education was not hindered by the rules. Another 27 percent stated that regulations were a minimal barrier to their education.

According to the researchers, a small majority of residents (52 percent) reported that the ideal number of hours for their training was 60 to 80, in line with the current regulations, while 43 percent believed that 80 to 100 hours per week would be ideal.

July 17, 2009
http://www.burrillreport.com/article-gluttons_for_punishment.html