A survey of residents and faculty regarding work hour limitations in surgical training programs

Mark J. Niederee, Jason L. Knudtson, Matthew C. Byrnes, Stephen D. Helmer, R. Stephen Smith, David R. Farley, Claude H. Organ, Stephen G. Jolley, Gary L. Dunnington, Rawson James Valentine, Donald E. Fry, Ramon Cestero, James R. DeBord

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Hypothesis: Surgical faculty and residents have significantly different attitudes regarding work hour restrictions. Setting: All general surgery residencies approved by the Accreditation Council for Graduate Medical Education (ACGME). Participants: All voluntarily participating surgical faculty and residents. Main Outcome Measures: Current hours worked, days off per month, and attitudes and opinions regarding the current surgical-training environment. Methods: A 17-question survey instrument was mailed to the program directors of all ACGME-approved surgical-training programs in the United States. They were requested to distribute the survey to all faculty and residents for completion and to return the forms for analysis. Results: Responses (N = 1653) were received from 46% of surgical-training programs. A significant difference was noted between faculty and resident responses in most categories. Most residents (87%) reported more than 80 duty hours per week, whereas 45% reported working more than 100 hours per week. Only 30% of residents reported an average of 1 day per week free of clinical activities. Although a minority of residents (43%) felt that their workload was excessive, 57% felt that their cognitive abilities had been impaired by fatigue. A significant number of residents (64%) and faculty (39%) believe that duty hour restrictions should be adopted. A minority of residents (20%) and faculty (47%) believe that the duration of residency training should be increased to compensate for duty hour restrictions. One quarter of residents regret choosing a career in surgery. Conclusions: Current duty hours for most surgical residents exceed the proposed ACGME limits. Although most residents support duty hour limits; surgical faculty are less supportive. Significant alterations in the current design and structure of surgical-training programs will be required to meet the ACGME guidelines.

Original languageEnglish (US)
Pages (from-to)663-671
Number of pages9
JournalArchives of Surgery
Volume138
Issue number6
DOIs
StatePublished - Jun 1 2003

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Graduate Medical Education
Accreditation
Education
Internship and Residency
A 17
Aptitude
Surveys and Questionnaires
Workload
Fatigue
Emotions
Outcome Assessment (Health Care)
Guidelines

ASJC Scopus subject areas

  • Surgery

Cite this

Niederee, M. J., Knudtson, J. L., Byrnes, M. C., Helmer, S. D., Smith, R. S., Farley, D. R., ... DeBord, J. R. (2003). A survey of residents and faculty regarding work hour limitations in surgical training programs. Archives of Surgery, 138(6), 663-671. https://doi.org/10.1001/archsurg.138.6.663

A survey of residents and faculty regarding work hour limitations in surgical training programs. / Niederee, Mark J.; Knudtson, Jason L.; Byrnes, Matthew C.; Helmer, Stephen D.; Smith, R. Stephen; Farley, David R.; Organ, Claude H.; Jolley, Stephen G.; Dunnington, Gary L.; Valentine, Rawson James; Fry, Donald E.; Cestero, Ramon; DeBord, James R.

In: Archives of Surgery, Vol. 138, No. 6, 01.06.2003, p. 663-671.

Research output: Contribution to journalArticle

Niederee, MJ, Knudtson, JL, Byrnes, MC, Helmer, SD, Smith, RS, Farley, DR, Organ, CH, Jolley, SG, Dunnington, GL, Valentine, RJ, Fry, DE, Cestero, R & DeBord, JR 2003, 'A survey of residents and faculty regarding work hour limitations in surgical training programs', Archives of Surgery, vol. 138, no. 6, pp. 663-671. https://doi.org/10.1001/archsurg.138.6.663
Niederee MJ, Knudtson JL, Byrnes MC, Helmer SD, Smith RS, Farley DR et al. A survey of residents and faculty regarding work hour limitations in surgical training programs. Archives of Surgery. 2003 Jun 1;138(6):663-671. https://doi.org/10.1001/archsurg.138.6.663
Niederee, Mark J. ; Knudtson, Jason L. ; Byrnes, Matthew C. ; Helmer, Stephen D. ; Smith, R. Stephen ; Farley, David R. ; Organ, Claude H. ; Jolley, Stephen G. ; Dunnington, Gary L. ; Valentine, Rawson James ; Fry, Donald E. ; Cestero, Ramon ; DeBord, James R. / A survey of residents and faculty regarding work hour limitations in surgical training programs. In: Archives of Surgery. 2003 ; Vol. 138, No. 6. pp. 663-671.
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abstract = "Hypothesis: Surgical faculty and residents have significantly different attitudes regarding work hour restrictions. Setting: All general surgery residencies approved by the Accreditation Council for Graduate Medical Education (ACGME). Participants: All voluntarily participating surgical faculty and residents. Main Outcome Measures: Current hours worked, days off per month, and attitudes and opinions regarding the current surgical-training environment. Methods: A 17-question survey instrument was mailed to the program directors of all ACGME-approved surgical-training programs in the United States. They were requested to distribute the survey to all faculty and residents for completion and to return the forms for analysis. Results: Responses (N = 1653) were received from 46{\%} of surgical-training programs. A significant difference was noted between faculty and resident responses in most categories. Most residents (87{\%}) reported more than 80 duty hours per week, whereas 45{\%} reported working more than 100 hours per week. Only 30{\%} of residents reported an average of 1 day per week free of clinical activities. Although a minority of residents (43{\%}) felt that their workload was excessive, 57{\%} felt that their cognitive abilities had been impaired by fatigue. A significant number of residents (64{\%}) and faculty (39{\%}) believe that duty hour restrictions should be adopted. A minority of residents (20{\%}) and faculty (47{\%}) believe that the duration of residency training should be increased to compensate for duty hour restrictions. One quarter of residents regret choosing a career in surgery. Conclusions: Current duty hours for most surgical residents exceed the proposed ACGME limits. Although most residents support duty hour limits; surgical faculty are less supportive. Significant alterations in the current design and structure of surgical-training programs will be required to meet the ACGME guidelines.",
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AU - Organ, Claude H.

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AU - Fry, Donald E.

AU - Cestero, Ramon

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N2 - Hypothesis: Surgical faculty and residents have significantly different attitudes regarding work hour restrictions. Setting: All general surgery residencies approved by the Accreditation Council for Graduate Medical Education (ACGME). Participants: All voluntarily participating surgical faculty and residents. Main Outcome Measures: Current hours worked, days off per month, and attitudes and opinions regarding the current surgical-training environment. Methods: A 17-question survey instrument was mailed to the program directors of all ACGME-approved surgical-training programs in the United States. They were requested to distribute the survey to all faculty and residents for completion and to return the forms for analysis. Results: Responses (N = 1653) were received from 46% of surgical-training programs. A significant difference was noted between faculty and resident responses in most categories. Most residents (87%) reported more than 80 duty hours per week, whereas 45% reported working more than 100 hours per week. Only 30% of residents reported an average of 1 day per week free of clinical activities. Although a minority of residents (43%) felt that their workload was excessive, 57% felt that their cognitive abilities had been impaired by fatigue. A significant number of residents (64%) and faculty (39%) believe that duty hour restrictions should be adopted. A minority of residents (20%) and faculty (47%) believe that the duration of residency training should be increased to compensate for duty hour restrictions. One quarter of residents regret choosing a career in surgery. Conclusions: Current duty hours for most surgical residents exceed the proposed ACGME limits. Although most residents support duty hour limits; surgical faculty are less supportive. Significant alterations in the current design and structure of surgical-training programs will be required to meet the ACGME guidelines.

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