Resident perceptions of the impact of work-hour restrictions on health care delivery and surgical education: time for transformational change.
BACKGROUND
The Accreditation Council for Graduate Medical Education has recently enacted an 80-hour workweek, which has been in effect in New York State for several years. We surveyed surgical residents from all four State University of New York (SUNY) surgical programs to determine their perceptions of the impact of the 80-hour workweek on patient care, surgical education, and personal life.


METHODS
A survey instrument to address the three areas of concern was developed and administered to all surgical residents at the four SUNY programs. Anonymity of the responders was maintained. Responses to the questions were in numeric rank scores and were analyzed by descriptive statistics, chi-square analysis, and analysis of variance.


RESULTS
Response rate was 59%. Factors perceived to be affected negatively by the residents were continuity and safety of care, their operative experience, and their relations with attendings. The factors affected positively were increased personal time and decreased fatigue at work. Interestingly, the latter did not appear to decrease the rate of medical errors in their perception.


CONCLUSIONS
The 80-hour workweek has the potential to have adverse effects on patient care despite improving the level of fatigue at work. Reengineering the surgical residencies will be needed to take full advantage of the restricted work hours.
Department of Surgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
Kara C
KC
Kort
Lucio A
LA
Pavone
Eric
E
Jensen
Enamul
E
Haque
Nancy
N
Newman
Dilip
D
Kittur
D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008019:Life Style; D009518:New York; D010465:Perception; D011787:Quality of Health Care; D013997:Time Factors; D016526:Workload / Q000523:psychology*