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Invited Critique
December 2001

Resident Work Hours: The Evolution of a Revolution—Invited Critique

Arch Surg. 2001;136(12):1432. doi:10.1001/archsurg.136.12.1432

The article by Drs Wallack and Chao is an accurate chronicle of public policy and politics in New York. The authors are supportive and justify their position by using recent resident-match results as evidence for a controllable lifestyle agenda. Still, training residents to provide surgical care now requires a fundamental change in vision and activity that involves more than limiting working hours. The real issues are service and training, supervision and communication.

In our experience, compliance requires controlled management of the clinical experience with specific goals and sufficient personnel to meet patient needs. The surgical waiver is limited by the vagueness of the definition of the words "generally resting," the difficulty in documentation of resident activity, and the adequacy of the methodology for seeking relief. This may provide a loophole in some circumstances but does not withstand scrutiny.

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