Should all duty hours be the same? Results of a national survey of surgical trainees.
BACKGROUND
Although duty hours regulations (DHR) were introduced as a measure to improve patient safety and graduate medical education, new evidence suggests that the opposite might be happening. This study was designed to assess surgery resident perceptions of the impact that DHR have had on their education, the number of hours they believed would be ideal for their training, and to evaluate the effect of seniority on these opinions.


METHODS
An Internet-based survey was electronically distributed to all Resident and Associate members of the American College of Surgeons.


RESULTS
Of 599 respondents, 247 (41%) believed that DHR were an important barrier to their education, and 266 (44%) believed that the ideal work week should have 80 to 100 hours. These two opinions were highly correlated, and were increasingly voiced with increased resident experience. Senior residents were more likely to view DHR as an important barrier to their education whether or not they were general surgery residents or were trained in small, medium, or large programs.


CONCLUSIONS
A large subset of surgery residents, particularly senior residents, considered DHR an important barrier to their education and expressed a desire to work longer hours than restrictions allow. These findings suggest that strict and uniform DHR do not allow for optimal training of residents at different levels who have disparate educational goals and needs. Introducing some flexibility into senior residents' limitations should be considered.
Moalem
Jacob
J
Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA. jacob_moalem@urmc.rochester.edu
Salzman
Peter
P
Ruan
Daniel T
DT
Cherr
Gregory S
GS
Freiburg
Carter B
CB
Farkas
Rachel L
RL
Brewster
Luke
L
James
Ted A
TA
D000328:Adult; D016009:Chi-Square Distribution; D004526:Efficiency; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D020407:Internet; D007396:Internship and Residency; D008297:Male; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States; D014940:Work Schedule Tolerance; D016526:Workload