Surgical Training, Duty-Hour Restrictions, and Implications for Meeting the Accreditation Council for Graduate Medical Education Core Competencies: Views of Surgical Interns Compared With Program Directors | Medical Education and Training | JAMA Network
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Original Article
June 2012

Surgical Training, Duty-Hour Restrictions, and Implications for Meeting the Accreditation Council for Graduate Medical Education Core Competencies: Views of Surgical Interns Compared With Program Directors

Author Affiliations

Author Affiliations: Department of Primary Care Internal Medicine (Dr Reed) and Department of Surgery (Drs Antiel, Heller, and Farley), Mayo Clinic, Rochester, Minnesota; and Departments of Surgery, The Johns Hopkins University, Baltimore, Maryland (Dr Van Arendonk), Vanderbilt University, Nashville, Tennessee (Drs Terhune and Tarpley), University of Alabama at Birmingham (Dr Porterfield), University of Pittsburgh, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (Dr Hall), Stanford University, Stanford, California (Dr Joyce), University of Chicago, Chicago, Illinois (Dr Wightman), and University of Washington, Seattle (Dr Horvath).

Arch Surg. 2012;147(6):536-541. doi:10.1001/archsurg.2012.89
Abstract

Objective To describe the perspectives of surgical interns regarding the implications of the new Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulations for their training.

Design We compared responses of interns and surgery program directors on a survey about the proposed ACGME mandates.

Setting Eleven general surgery residency programs.

Participants Two hundred fifteen interns who were administered the survey during the summer of 2011 and a previously surveyed national sample of 134 surgery program directors.

Main Outcome Measures Perceptions of the implications of the new duty-hour restrictions on various aspects of surgical training, including the 6 ACGME core competencies of graduate medical education, measured using 3-point scales (increase, no change, or decrease).

Results Of 215 eligible surgical interns, 179 (83.3%) completed the survey. Most interns believed that the new duty-hour regulations will decrease continuity with patients (80.3%), time spent operating (67.4%), and coordination of patient care (57.6%), while approximately half believed that the changes will decrease their acquisition of medical knowledge (48.0%), development of surgical skills (52.8%), and overall educational experience (51.1%). Most believed that the changes will improve or will not alter other aspects of training, and 61.5% believed that the new standards will decrease resident fatigue. Surgical interns were significantly less pessimistic than surgery program directors regarding the implications of the new duty-hour restrictions on all aspects of surgical training (P < .05 for all comparisons).

Conclusions Although less pessimistic than program directors, interns beginning their training under the new paradigm of duty-hour restrictions have significant concerns about the effect of these regulations on the quality of their training.

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