A Survey of Residents and Faculty Regarding Work Hour Limitations in Surgical Training Programs

Abstract

Hypothesis: Surgical faculty and residents have significantly different attitudes regarding work hour restrictions.Setting: All general surgery residencies approved by the Accreditation Council for Graduate Medical Education (ACGME).Participants: All voluntarily participating surgical faculty and residents.Main Outcome Measures: Current hours worked, days off per month, and attitudes and opinions regarding the current surgical-training environment. Methods:A 17-question survey instrument was mailed to the program directors of all ACGME-approved surgicaltraining programs in the United States. They were requested to distribute the survey to all faculty and residents for completion and to return the forms for analysis. Results: Responses (N = 1653) were received from 46% of surgical-training programs. A significant difference was noted between faculty and resident responses in most categories. Most residents (87%) reported more than 80 duty hours per week, whereas 45% reported working more than 100 hours per week. Only 30% of residents reported an average of 1 day per week free of clinical activities. Although a minority of residents (43%) felt that their workload was excessive, 57% felt that their cognitive abilities had been impaired by fatigue. A significant number of residents (64%) and faculty (39%) believe that duty hour restrictions should be adopted. A minority of residents (20%) and faculty (47%) believe that the duration of residency training should be increased to compensate for duty hour restrictions. One quarter of residents regret choosing a career in surgery.Conclusions: Current duty hours for most surgical residents exceed the proposed ACGME limits. Although most residents support duty hour limits; surgical faculty are less supportive. Significant alterations in the current design and structure of surgical-training programs will be required to meet the ACGME guidelines.

Effects of Resident Duty-Hours Restrictions on Surgical and Nonsurgical Teaching Faculty

“…Results were compared based on respondents' age (by decade), sex, and departmental affiliation (eg, ear, nose, and throat surgery; neurosurgery; obstetrics/gynecology; ophthalmology; orthopedic surgery; general surgery; and urology were deemed surgical specialties; all other departments were deemed nonsurgical). 2 Analysis was used to compare categorical responses to each question. t Tests were used to compare continuous variables (eg, age) between groups.…”

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15] Some concerns of limiting resident duty hours were the effects on resident education and exposure and effects on patient care. [3][4][5]16,17 However, based on data collected by the Accreditation Counsel of Graduate Medical Education and individual institutions, work-hours restrictions have not affected operative cases for surgical residents.…”

Impact of the ACGME Work Hour Requirements

“…Pre-ACGME guideline implementation, discussions were loudest in the surgical literature where it was questioned whether residents could get an adequate education with an 80-hour weekly limit. 12,13 In fact, almost all current requests to the ACGME for the 10% extension of this limit (to an 88-hour weekly limit) have been filed and granted for surgical specialties. The Neurology RRC will not consider requests for this extension.…”

Stability and Preference Alignment in Matching and Coalition Formation

“…The majority of residents surveyed by Niederee, Knudtson, Byrnes, Helmer, and Smith (2003), and Brunworth and Sindwani (2006) supported the restriction, while the majority of teaching hospitals' faculties opposed it.…”