The authors report on results from a survey assessing the attitudes of medical residents toward the American Osteopathic Association and the Accreditation Council for Graduate Medical Education duty-hour standards that became effective for all accredited residency programs on July 1, 2003. Data were gathered from 128 residents in four medical specialties: family medicine, general surgery, internal medicine, and obstetrics and gynecology. Participating residents worked at four teaching hospitals with allopathic, osteopathic, or dual-accredited programs. The dominant response of medical residents to duty-hour restrictions is clearly-though not uniformly-positive. Residents tend to agree that there are safety benefits for patients and quality-of-life benefits for themselves. A consistent pattern of positive responses toward the standards among internal medicine residents contrasts with less favorable responses among residents in general surgery programs. Gender differences are noted as well, with women generally more positive about duty-hour restrictions than their male colleagues. Male residents in surgery and obstetrics especially tend to agree that duty-hour restrictions could have negative effects on physician education with regard to their continuity of experience. The most consistent pattern in resident survey responses appears to be by medical specialty, perhaps reflecting variations in the nature of patient care and contact in each specialty.
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J Surg Educ
December 2024
Department of Surgery, Veterans Affairs of New Jersey Healthcare System, East Orange, New Jersey. Electronic address:
Purpose: Surgical resident autonomy in procedures has been eroding over time, due to multiple factors that include duty hour restrictions, focus on operating time, complication rate, and trust among supervising physicians. This study examines whether urology residents at the Veterans Affairs hospitals (VA) have experienced decreased surgical autonomy and contributing factors.
Methods: The national VA Surgical Quality Improvement Program (VASQIP) was queried for the most common urologic procedures between 2004 to 2019 with resident involvement.
JAMA Surg
December 2024
Department of Surgery, University of California, San Diego Health, La Jolla.
Importance: Since work-hour restrictions were instituted in 2003, sustainably complying with duty-hour regulations remains a challenge for general surgery residency programs across the nation.
Objective: To determine whether industry-based process improvement techniques could be leveraged to increase compliance with work-hour restrictions within a general surgery residency.
Design, Setting, And Participants: This quality improvement project using Lean methodology was conducted from October to November of the 2021 to 2022 academic year.
J Patient Exp
December 2024
Center for General Medicine Education, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan.
The aim of the study was to examine laypeople's perspectives on the impending implementation of physician work-hour restrictions in Japan, which had received limited research attention. We conducted a nationwide cross-sectional study in January 2024. The participants were monitors of an internet survey company who responded to closed questions regarding the expected effect of work-hour regulations, along with an open-ended question regarding their expectations or concerns about these restrictions.
View Article and Find Full Text PDFJ Surg Res
November 2024
Rush University Medical Center, Chicago, Illinois.
Introduction: Given the high incidence rate of breast cancer and shortage of fellowship trained specialists, general surgeons are frequently responsible for these patients. Residents have less operative exposure to breast surgery due to duty hour restrictions and decreased resident autonomy. We created a curriculum using human donors designed to teach junior residents to perform breast lumpectomy and sentinel lymph node biopsies.
View Article and Find Full Text PDFJ R Coll Physicians Edinb
September 2024
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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