title: Appropriate working hours for surgical training according to Australasian trainees.
abstract: BACKGROUND
  The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees.
  
  
  METHODS
  All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly 'sleep loss hours' (<8 per night) because of 24-h calls were defined. These work practices were then correlated with sufficiency of training time, time for study, fatigue and its impacts, and work-life balance preferences. Multivariate and univariate analyses were performed.
  
  
  RESULTS
  The response rate was 55.3% with responders representative of the total trainee body. Trainees who worked median 60 h/week (interquartile range: 55-65) considered their work hours to be appropriate for 'technical' and 'non-technical' training needs compared with 55 h/week (interquartile range: 50-60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly 'sleep loss hours', was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work-life balance worked median 55 h/week.
  
  
  CONCLUSIONS
  Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation.
authors.affiliation: Royal Australasian College of Surgeons' Trainees Association, Melbourne, Victoria, Australia. gog@ps.gen.nz
authors.forename: Gregory
authors.initials: G
authors.lastname: O'Grady
authors.forename: Simon
authors.initials: S
authors.lastname: Harper
authors.forename: Benjamin
authors.initials: B
authors.lastname: Loveday
authors.forename: Brandon
authors.initials: B
authors.lastname: Adams
authors.forename: Ian D
authors.initials: ID
authors.lastname: Civil
authors.forename: Matthew
authors.initials: M
authors.lastname: Peters
mesh_terms: D001315:Australia; D003625:Data Collection; D005221:Fatigue; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D009520:New Zealand; D012892:Sleep Deprivation; D014940:Work Schedule Tolerance