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Are Younger Surgeons Less Prepared?

Study examines experiential effects of residency work-week limits.

Published: December 12, 2013

In an effort to protect health and safety, accreditation authorities have imposed strict limits on the number of hours that surgical residents are allowed to work. But what if those limits leave young surgeons unprepared to handle their jobs?

A study published in the September 2013 issue of the Annals of Surgery examines the implications of that question.

For the study, researchers surveyed the directors of fellowship training programs on their new enrollees' skills. The directors reportedly found them unable to independently make clinical decisions, perform basic procedures or spot early complication symptoms.

"With limits set on their time at the hospital, young surgeons-in-training had fewer opportunities to care for patients or scrub in on operations," wrote Pauline W. Chen, MD, in the The New York Times. "Calculating the number of hours 'lost' by cutting back on in-hospital time, surgical leaders estimated that young surgeons-to-be were now missing out on as much as a year's worth of experience."

Trading marathon work-weeks for simulations, observers note, may simply require surgeons-in-training to undertake more years of training before they practice. "Things needed to change, but not recognizing the potential long-term effects was dangerous," says Frank R. Lewis, MD, executive director of the American Board of Surgery in Dr. Chen's column. "Even issues that seem completely obvious and one-sided can sometimes have significant consequences."

David Bernard


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