title: Follow-up on a national survey: american neurosurgery resident opinions on the 2011 accreditation council for graduate medical education-implemented duty hours.
abstract: OBJECTIVE
  We previously performed a nationwide survey of American neurosurgical residents before the initiation of the 2011 Accreditation Council for Graduate Medical Education regulations, in which more than 70% indicated the proposed changes would negatively impact residency training. We sought to resurvey the resident population as to the actual changes that occurred to their programs after the 2011 standards went into effect.
  
  
  METHODS
  Surveys were mailed to every neurosurgery training program in the United States and Puerto Rico. Program directors and coordinators were asked to distribute surveys to their residents.
  
  
  RESULTS
  A total of 253 neurosurgery residents responded. Reported duty-hour violations were largely unchanged after the 2011 duty-hour changes. Sixty-percent of residents reported that they had underreported duty hours, with nearly 25% of respondents doing so on a weekly or daily basis. Most reported that the 2011 changes had not affected operative caseload, academic productivity, quality of life, or resident fatigue. The majority of residents disagreed or strongly disagreed that the PGY-1 16-hour limitation had a positive impact on first-year resident training (69%) or had improved patient safety (62%). Overall, the majority of respondents reported that the 2011 changes had a negative (35%) or negligible (33%) effect on residency training at their institution.
  
  
  CONCLUSIONS
  Respondents indicated that the 2011 Accreditation Council for Graduate Medical Education regulations have had a smaller perceived effect on neurosurgical training programs than previously predicted. However, the majority of residents admitted to underreporting duty hours, with a quarter doing so on a regular basis. The 16-hour rule for interns remains unpopular.
authors: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA. Electronic address: kyle.fargen@neurosurgery.ufl.edu.
authors: Kyle M
authors: KM
authors: Fargen
authors: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
authors: Jamie
authors: J
authors: Dow
authors: Department of Neurosurgery, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA.
authors: Krystal L
authors: KL
authors: Tomei
authors: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
authors: William A
authors: WA
authors: Friedman
mesh_terms: D000068:Accreditation; D000328:Adult; D001291:Attitude of Health Personnel; D003625:Data Collection; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D009493:Neurosurgery / Q000193:education*; D012959:Socioeconomic Factors; D014481:United States; D014940:Work Schedule Tolerance; D016526:Workload
keywords: Accreditation Council for Graduate Medical Education; Duty-hour restrictions; Neurosurgery; Resident; Survey