Surgical residents in the United States are currently restricted to working less than 80 hours per week.
If you think that’s extreme, consider what’s happening the UK, where surgeons are capped at 58 hours per week (via Dr. Wes). Furthermore, that cap is set to go down to 48 hours.
Apparently, these caps are rarely enforced, as “only 25% of surgeons think their human resource departments accurately reflect their actual working hours,” and, “85% come in to do surgery on their days off.”
The simple fact is that there are not enough surgeons to cover the needed procedures as doctors are forced to go home, or take breaks. Also, physicians-in-training worry about the lack of experience needed to become proficient surgeons.
We should keep a close eye on the consequences that the UK will suffer as we debate whether further cut back resident work hours Stateside.
Are the supposed gains in patient safety compromised by producing a generation of lesser-trained surgeons, conditioned to punch out at the clock?
Related posts:
- The steep price of restricting resident work-hours
- Surgeons don’t receive enough training when resident work-hours are capped
- Restricting resident work hours forces doctors to lie, and other unintended consequences of the 80-hour work week
- Resident work hours: An alternative view
- How work-hour restrictions harms resident surgeon training
- Doctors lose a part of their training when resident work-hours are capped
- Resident work hour restrictions
{ 3 comments }
Its not just the hours. Its so much more.
1. Hours are an issue, but thank goodness that the U.S. is not capped (I have been in the hospital for much more than 80 hours this week. a very conservative estimate).
2. The number of general surgeon graduates in the U.S. have remained flat for over 30 years (approximately 1000 / yr.). Of course, the number graduating as general surgeons is siphoned off to other specialty areas (CV, Vascular, Colorectal, Surg Onc, etc). Therefore the per capita ratio has dramatically declined.
3. Surgical education has not changed YET. We are working on it and Dr. Barbara Bass, my chairman and past president of the American Board of Surgery, is actively working very hard to define the future of medical training. It must change because as it stands now residents graduating from general surgery programs will have more of a challenge knowing how to do certain things than their predecessors.
My opinion is that we need to stop focusing on the hours, and start coming up with innovative solutions that will improve the quality and efficiency of surgical training. Dr. Bass is doing just that.
Doctors who trained without work hours restrictions are constantly saying that the new work hours lead to doctors who “are conditioned to punch out with the clock.” The truth is that the majority of residents are staying far beyond the hours recommended (at least in my experience; I only know how things work at my own institution). We generally sign out on time, but continue to do work that needs to be done. The new team takes care of new admissions, while the team that signed out is wrapping things up for the patients that are already there, then leave. It’s not like we say, it’s 7:00, time to leave, and just fly out of there.
When will attendings see that work hours are changing regardless of how much fight they put up. The demographic of residents entering medicine is different than it was 20 years ago. The new residents have more responsibilities at home and elsewhere than in the past. For a more in depth explanation read http://www.associatedcontent.com/article/1288635/resident_work_hour_restrictions_impending.html?cat=5
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