A new professionalism? Surgical residents, duty hours restrictions, and shift transitions.
BACKGROUND
Some anticipated that the Accreditation Council for Graduate Medical Education duty hours restrictions would foster a team-focused "new professionalism" among residents. This study explores the prevalence and challenges of a new professionalism and whether they vary by program size.


METHODS
Questionnaires distributed in 15 general surgery programs produced an 82% response rate (N = 306); 52 semistructured follow-up interviews were completed. Results include means, percentage who "agree or strongly agree," significance tests, and main themes from the interviews.


RESULTS
A new professionalism is limited by residents' reluctance to pass work from day to night teams, unclear guidance regarding stay-or-go decisions during shift transitions, little educational emphasis on sign-outs, and the practice of long hours in the name of professionalism. Program size is largely unassociated with these beliefs and behaviors.


CONCLUSIONS
A new professionalism represents a stalled revolution among surgical residents. The new professionalism's emphasis on teamwork requires additional attention to staffing and workload management.
Coverdill
James E
JE
Department of Sociology, University of Georgia, Athens, GA 30602, USA. jimcov@uga.edu
Carbonell
Alfredo M
AM
Fryer
Jonathan
J
Fuhrman
George M
GM
Harold
Kristi L
KL
Hiatt
Jonathan R
JR
Jarman
Benjamin T
BT
Moore
Richard A
RA
Nakayama
Don K
DK
Nelson
M Timothy
MT
Schlatter
Marc
M
Sidwell
Richard A
RA
Tarpley
John L
JL
Termuhlen
Paula M
PM
Wohltmann
Christopher
C
Mellinger
John D
JD
D003657:Decision Making; D004503:Education, Medical, Graduate; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007407:Interviews as Topic; D010561:Personnel Staffing and Scheduling; D011364:Professional Practice; D011795:Surveys and Questionnaires; D014481:United States; D014940:Work Schedule Tolerance; D016526:Workload