title: Effect of the ACGME duty hours restrictions on surgical residents and faculty: a systematic review.
abstract: OBJECTIVE
  Educators in surgical training programs are concerned that the Accreditation Council for Graduate Medical Education (ACGME) duty hours limitations may adversely affect surgical residents' education, especially their operative experience, so the authors aimed to evaluate the impact of duty hours reductions on surgical residency.
  
  
  METHODS
  The authors searched English- and French-language literature (2000-2008) for articles about the impact of duty hours restrictions on surgical residents' education and well-being and on faculty educators. They used the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ERIC. The authors included every report that examined the effects of duty hours limits on surgical training, excluding opinion papers and editorials. Two reviewers independently performed data extraction and quality assessment for all reports and resolved disagreements by consensus.
  
  
  RESULTS
  The authors retrieved 1,146 reports and included 56 in the study. They compiled positive and negative outcomes on (1) residents' education, (2) resident lifestyle, and (3) surgical faculty. Overall, the effects of duty hours reductions on residents' education and lifestyle were positive or neutral, but the effects on surgical faculty were negative. The 16 articles with the highest-quality scores had 27 positive themes and 11 negative themes.
  
  
  CONCLUSIONS
  This is the largest and most current review of the literature addressing the effect of the ACGME duty hours limitations on surgical training. Limitations had a positive effect on residents but a negative effect on surgical faculty. Importantly, duty hours limitations did not adversely affect surgical residents' operating-room experience.
authors.affiliation: General Surgery, Department of Surgery and Centre for Medical Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Mohammad.jamal@mail.mcgill.ca
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Jamal
authors.forename: Mathieu C
authors.initials: MC
authors.lastname: Rousseau
authors.forename: Wael C
authors.initials: WC
authors.lastname: Hanna
authors.forename: Suhail A R
authors.initials: SA
authors.lastname: Doi
authors.forename: Sarkis
authors.initials: S
authors.lastname: Meterissian
authors.forename: Linda
authors.initials: L
authors.lastname: Snell
mesh_terms: D005180:Faculty, Medical / Q000458:organization & administration*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D016526:Workload / Q000706:statistics & numerical data*