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Original Article
June 2010

Effect of the 50-Hour Workweek Limitation on Training of Surgical Residents in Switzerland

Author Affiliations

Author Affiliations: Department of General Surgery and Surgical Research, University Hospital Basel, Basel (Drs Businger and Oertli), and Division of Visceral Surgery and Transplantation, Department of Surgery, University Hospital Bern, Bern (Drs Businger and Guller), Switzerland.

Arch Surg. 2010;145(6):558-563. doi:10.1001/archsurg.2010.88

Hypothesis  The 50-hour workweek limitation for surgical residents in Switzerland has a major effect on surgical training, resident quality of life, and patient care.

Design  Survey study.

Setting  Residencies in Switzerland.

Participants  Surgical residents and surgical consultants.

Main Outcome Measures  An anonymous survey was conducted in Switzerland. Of 93 surgical departments contacted, 52 (55.9%) responded; of their 281 surgical residents and 337 surgical consultants, 405 (65.5%) returned a completed survey.

Results  Residents and consultants indicated a negative effect of the 50-hour workweek limitation on surgical training (62.8% and 77.2%, respectively) and on quality of patient care (43.0% and 70.1%, respectively) (P < .001 for both). Most residents and consultants reported that operative time (76.9% and 73.4%, respectively) and overall operating room experience (73.8% and 84.8%, respectively) were negatively affected by the work hour limitation. Only 8.1% of residents and 4.9% of consultants perceived the work hour limitation as beneficial to surgical training. Conversely, 58.4% of residents and 81.5% of consultants considered that residents' quality of life had improved (P < .001).

Conclusions  Most surgical residents and surgical consultants perceive the work hour limitation as having a negative effect on surgical training and on the quality of patient care. Despite somewhat improved resident quality of life, the work hour limitation for surgical residencies in Switzerland appears to be a failure.