Comments on: Restricting resident work hours leads to a shortage of surgeons http://www.kevinmd.com/blog/2009/01/restricting-resident-work-hours-leads.html Tue, 14 Feb 2012 19:56:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2009/01/restricting-resident-work-hours-leads.html#comment-89512 Anonymous Sat, 31 Jan 2009 18:45:00 +0000 http://clients.emmense.com/kevinmd/2009/01/restricting-resident-work-hours-leads-to-a-shortage-of-surgeons.html#comment-89512 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 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

]]> By: Anonymoushttp://www.kevinmd.com/blog/2009/01/restricting-resident-work-hours-leads.html#comment-89437 Anonymous Tue, 27 Jan 2009 16:08:00 +0000 http://clients.emmense.com/kevinmd/2009/01/restricting-resident-work-hours-leads-to-a-shortage-of-surgeons.html#comment-89437 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. 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.

]]> By: Joseph Sucher, MD FACShttp://www.kevinmd.com/blog/2009/01/restricting-resident-work-hours-leads.html#comment-89436 Joseph Sucher, MD FACS Tue, 27 Jan 2009 15:30:00 +0000 http://clients.emmense.com/kevinmd/2009/01/restricting-resident-work-hours-leads-to-a-shortage-of-surgeons.html#comment-89436 Its not just the hours. Its so much more.<br/><br/>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). <br/><br/>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.<br/><br/>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.<br/><br/>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. 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.

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