Hypothesis: With the introduction of the newly mandated restrictions on resident work hours, we expected improvement in subjective feelings of personal accomplishment and lessened emotional exhaustion and depersonalization. Design: Residents and faculty members completed an anonymous online Maslach Burnout Inventory Human Services Survey (3rd ed; Consulting Psychologist Press Inc, Palo Alto, Calif) and work-hour registry before and after implementation of new restrictions. Setting: Urban, university-based department of surgery. Participants: All house staff (n=37) and faculty (n=27). Intervention: Introduction of new Institutional Standards for Resident Duty Hours 2003. Main Outcome Measure: Resident work hours and levels of emotional exhaustion, perceived degree of depersonalization, and personal accomplishment. Results: Resident work hours per week decreased from 100.7 to 82.6 (PϽ.05) with introduction of the new schedule. Home call and formal educational activity time within working hours (eg, clinical conferences) significantly (PϽ.05) decreased from 11.5 and 4.8 hours to 4.6 and 2.5 hours per week, respectively. Operating room hours, clinic time, and duration of rounds did not show a significant change. Changes in parameters of resident and faculty emotional exhaustion, depersonalization, and personal accomplishment did not show statistical significance (PϾ.05).Conclusions: Despite successful reductions in resident work hours, measures of burnout were not significantly affected. However, important clinical activities such as time spent in the operating room, clinic, and making rounds were maintained. Formal in-hospital education time was reduced.

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Thoracoscopic repair of esophageal atresia and tracheoesophageal fistula is feasible, but is technically challenging. Long-gap defects require more extensive dissection and difficult anastomosis, and are therefore associated with longer operative times. More data are needed for further evaluation of this approach.