Viewpoints from generation X: a survey of candidate and associate viewpoints on resident duty-hour regulations

Abstract

Background: The American Medical Student Association, the Committee of Interns and Residents, and Public Citizen petitioned the Occupational Safety and Health Administration for national resident duty-hour limitations. Subsequently, federal legislation was introduced to limit resident duty hours. To preempt the federal government, the Accreditation of Graduate Medical Education implemented resident duty-hour guidelines.

Study design: To evaluate the viewpoints and attitudes of surgical resident and staff physicians as they pertain to the national resident duty-hour guidelines, we asked attendees of the American College of Surgeons' Candidate Associate Society Forum during the American College of Surgeons Clinical Congress meeting in 2001 to complete a self-administered questionnaire. Analyses were performed to determine the frequency of response for each survey item.

Results: Eighty-six of the 102 (84%) surgeons who attended the American College of Surgeons Forum completed the survey. Most disagreed with the federal government involvement in regulating duty hours. Although most agreed that residents should not be on call more than every third night, viewpoints varied on the other duty-hour guidelines. Most (63.4%) reported that residents should work 81 to 100 hours per week, but 11% reported that residents should work > 101 hours per week and 25.6% reported that <or= 80 hours per week was optimal.

Conclusions: As future guidelines are considered, further studies must be done to determine the viewpoints and attitudes of surgical resident and staff physicians with regard to resident duty-hour reform. These "front line" individuals may have unique insights into the benefits and barriers of duty-hour regulations.