scholarly journals Work Hour Regulations: Do We Need Further Changes Now? A Survey of Internal Medicine Faculty and Residents

2009 ◽  
Vol 1 (2) ◽  
pp. 201-207 ◽  
Author(s):  
Susan Sloan ◽  
Mahesh Krishnamurthy ◽  
David T. Lyon ◽  
Ghada Mitri ◽  
Iryna Chyshkevych ◽  
...  
Keyword(s):  
The United States ◽  
Work Hours ◽  
First Year ◽  
Institute Of Medicine ◽  
Resident Work ◽  
Work Hour ◽  
Internal Medicine Faculty ◽  
Home Residency ◽  
Residency Program Directors ◽  
Resident Work Hours

Abstract Background In 2003, the Accreditation Council for Graduate Medical Education standardized and regulated work hours for physicians in training in the United States. In December 2008, the Institute of Medicine (IOM) recommended further reductions in duty hours to ensure safer conditions for patients and residents and fellows. Significantly, the IOM committee acknowledged that there are barriers to implementing its recommendations. Methods In the wake of the IOM proposals, we chose to survey a reference closer to home: residency program directors, faculty, and residents. Our survey allowed them the opportunity to express their opinions regarding the IOM proposals. Results The majority of the faculty oppose the proposed IOM changes, arguing that there is no definite evidence to support the hypothesis that fewer work hours mean better outcomes in patient safety and education. First-year residents and residents who moonlight were more likely to experience stress and to support decreased work hours. Conclusions The thoughts and opinions of faculty and residents collected through this survey, in combination with evidence-based studies from trial implementation of these standards, will contribute real answers to the challenging questions on resident work hours.

Resident duty hour regulation and patient safety: establishing a balance between concerns about resident fatigue and adequate training in neurosurgery

2009 ◽  
Vol 110 (5) ◽  
pp. 828-836 ◽  
Author(s):  
M. Sean Grady ◽  
H. Hunt Batjer ◽  
Ralph G. Dacey
Keyword(s):  
Patient Safety ◽  
Work Force ◽  
External Pressure ◽  
Work Hours ◽  
Institute Of Medicine ◽  
The Public ◽  
The Past ◽  
Resident Work ◽  
Neurological Surgery ◽  
Resident Work Hours

Postgraduate training in medicine has been under scrutiny over the past 10 years with a major focus on physician personal health and patient safety. The culmination of a series of events led to the 80-hour work week instituted by the Accreditation Council on Graduate Medical Education in 2003. The effect this mandate has had on surgical education, and specifically training in neurological surgery, has been incompletely evaluated. Nevertheless, external pressure has prompted the Institute of Medicine to issue a new report on resident work hours and patient safety. In this report, the authors focus on the unique aspects of neurosurgical training in which physicians are trained to safely and effectively carry out complex high-risk tasks, the experience from abroad where work hours are reduced to well below 80 hours/week, and the risk that further reduction in work hours poses to the public. The authors conclude that there must be an adequate balance between the risks associated with resident fatigue and those associated with an inexperienced neurosurgical work force for public health.

scholarly journals Resident work hours: why keeping the status quo may not be such a bad thing

2013 ◽  
Vol 4 (2) ◽  
pp. e56-e62
Author(s):  
Roshan Razik ◽  
Marat Slessarev
Keyword(s):  
First Year ◽  
Call Structure ◽  
Resident Work ◽  
The Us ◽  
Government Hospitals ◽  
Canadian Perspective ◽  
The Status ◽  
Work Hour ◽  
Future Work ◽  
Resident Work Hours

Resident duty hours have become an increasingly debated topic in post-graduate medical education. Work-hour restrictions have been implemented for first-year residents in the US and more recently for all residents in Quebec. Current and future work-hour rules affect a variety of stakeholders: government, hospitals, residency training programs, patients, and most of all residents. In this article, we hope to examine the issue from a Canadian perspective and delineate some of the reasons why changing the current call structure may have potentially deleterious effects to all those concerned.

Fatigue, Resident Work Hours, and Safety

Medical Care ◽  
2009 ◽  
Vol 47 (7) ◽  
pp. 711-713
Author(s):  
David W. Bates
Keyword(s):  
Work Hours ◽  
Resident Work ◽  
Resident Work Hours

Systematic Review: Effects of Resident Work Hours on Patient Safety

2004 ◽  
Vol 141 (11) ◽  
pp. 851 ◽  
Author(s):  
Kathlyn E. Fletcher ◽  
Steven Q. Davis ◽  
Willie Underwood ◽  
Rajesh S. Mangrulkar ◽  
Laurence F. McMahon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Work Hours ◽  
Resident Work ◽  
Resident Work Hours

Restricting resident work hours

2012 ◽  
Vol 40 (8) ◽  
pp. 2532-2533
Author(s):  
Adam Peets ◽  
Najib Ayas
Keyword(s):  
Work Hours ◽  
Resident Work ◽  
Resident Work Hours

Resident Work Hours

2001 ◽  
Vol 136 (12) ◽  
pp. 1426 ◽  
Author(s):  
Claude H. Organ
Keyword(s):  
Work Hours ◽  
Resident Work ◽  
Resident Work Hours

scholarly journals Assessment of Intravitreal Injection Training among U.S.-Based Ophthalmology Residents

2019 ◽  
Vol 11 (01) ◽  
pp. e43-e49
Author(s):  
Jacob J. Liechty ◽  
Michael J. Wilkinson ◽  
Esther M. Bowie
Keyword(s):  
United States ◽  
Intravitreal Injection ◽  
Povidone Iodine ◽  
The United States ◽  
Intravitreal Injections ◽  
First Year ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Program Directors ◽  
Procedure Room

Purpose To describe the intravitreal injection training of ophthalmology residents in the United States in 2018. Design Cross-sectional survey. Methods An anonymous, 29-question, internet-based survey was emailed to 119 ophthalmology residency program directors with the instructions to forward the survey to their ophthalmology residents. Results A total of 117 ophthalmology residents (7.89%) responded to the survey. The majority of residents stated that their intravitreal injection training began during their first year of ophthalmology training, PGY 2 year, (92.3%). The majority of residents performed at least 25 injections per year (78.6%). All residents use antiseptic on the conjunctiva prior to the injection, 94% use a lid speculum, and 84.6% avoided talking in the procedure room. Most injections are performed with gloves (83.8%). A minority of residents stated that they are trained to use povidone-iodine on the eyelids prior to performing an injection (45.3%). Only 6.0% of residents claimed to use postinjection antibiotic drops. Performance of bilateral, simultaneous intravitreal injections was split with nearly half of residents not being trained in this method (47.9%). Conclusion Ophthalmology residents from across the country experience a variety of different injection protocols when being trained on how to perform intravitreal injections. Conjunctival antisepsis has reached a clear consensus while topics such as simultaneous, bilateral injections and eyelid antisepsis are still uncertain among the resident community.

Are Resident Work-Hour Limitations Beneficial to the Trauma Profession?

2006 ◽  
Vol 72 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Tara Abraham ◽  
Marilee Freitas ◽  
Spiros Frangos ◽  
Heidi L. Frankel ◽  
Reuven Rabinovici
Keyword(s):  
General Surgery ◽  
National Level ◽  
Work Hours ◽  
Emergency General Surgery ◽  
Duty Hours ◽  
Likert Score ◽  
Resident Work ◽  
Work Hour ◽  
Resident Duty ◽  
Level I

In July 2003, work-hour restrictions were implemented by the Accreditation Council for Graduate Medical Education (ACGME) to limit resident duty hours. Attending surgeon work-hours have not been similarly reduced, and many trauma services have added emergency general surgery responsibilities. We hypothesized that trauma attending/resident work-hour disparity may disincentivize residents from selecting trauma careers and that trauma directors would view ACGME regulations negatively. We conducted a 6-month study of resident and in-house trauma attending self-reported hours at a level I trauma center and sent a questionnaire to 172 national level I trauma directors (TDs) regarding work-hours restrictions. TD survey response rate was 48 per cent; 100 per cent of 15 residents and 6 trauma faculty completed work-hour logs. Attending mean hours (87.1/ wk), monthly calls (5), and shifts >30 hours exceeded that of all resident groups. Case volume was similar. Residents viewed their lifestyle more favorably than the lifestyle of the trauma attending (Likert score 3.6 ± 0.5 vs Likert score 2.5 ± 0.8, P = 0.0003). Seventy-one per cent cited attending work hours and lifestyle as a reason not to pursue a trauma career. Nationally, 80 per cent of trauma surgeons cover emergency general surgery; 40 per cent work greater than 80 hours weekly, compared with <1 per cent of surgical trainees (P < 0.0001). Most TDs feel that residents do not spend more time reading (89%) or operating (96%); 68 per cent feel patient care has suffered as a result of duty-hours restrictions. Seventy-one per cent feel residents will not select trauma surgery as a career as a result of changes in duty hours. Perceived trauma attending/resident work-hour disparity may disincentive trainees from trauma career selection. TDs view resident duty-hour restrictions negatively.

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