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Article
July 1992

Guidelines for Surgical Residents' Working HoursIntent vs Reality

Author Affiliations

From the Department of Surgery, Harbor-UCLA Medical Center, Torrance, Calif.

Arch Surg. 1992;127(7):778-783. doi:10.1001/archsurg.1992.01420070030008
Abstract

• To comply with voluntary California medical school guidelines, our general surgery residency program reduced in-house call to 1 in 4 nights, and scheduled a 72-hour workweek. We assessed the effectiveness of these changes by prospectively surveying the actual working hours of surgical house staff through completion of a daily schedule for 1 month. Actual in-hospital hours averaged 98 per week, significantly exceeding the scheduled hours, and were greater for interns (100 hours) and junior residents (97 hours) than for chief residents (95 hours). Twenty hours (22%) of nonconference waking hours were spent on so-called scut work. Significant reduction of intern work hours could be accomplished by expansion of ancillary care, allowing more time for direct patient care. The effect on senior house staff hours would be less dramatic but might be sufficient to bring hours into compliance with proposed limits.

(Arch Surg. 1992;127:778-783)

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