Related Experiment Videos
Guidelines for surgical residents' working hours. Intent vs reality
R J Schwartz1, T J Dubrow, R F Rosso
1Department of Surgery, Harbor-UCLA Medical Center, Torrance 90509.
Archives of Surgery (Chicago, Ill. : 1960)
|July 1, 1992
Summary
General surgery residents exceeded scheduled work hours despite program changes. Reducing scut work and expanding ancillary care could decrease resident work hours.
Area of Science:
- Medical Education
- Surgical Training
- Work Hour Regulations
Background:
- California medical schools voluntarily reduced in-house call to 1 in 4 nights and scheduled a 72-hour work-week for general surgery residents.
- Assessing the impact of these changes on actual resident working hours was crucial.
Framework:
- Prospective survey of surgical house staff working hours.
- Daily schedule completion by residents over a 1-month period.
- Analysis of actual in-hospital hours versus scheduled hours.
Implementation:
- Actual in-hospital hours averaged 98 per week, exceeding the scheduled 72-hour work-week.
- Interns (100 hours) and junior residents (97 hours) worked more than chief residents (95 hours).
- Twenty percent of non-conference waking hours were dedicated to administrative tasks ('scut work').
Implications:
- Significant reduction in intern work hours is achievable through enhanced ancillary care services.
- Expansion of ancillary care can allow more time for direct patient care activities.
- Senior house staff hours may approach compliance with proposed limits with these adjustments.