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Shorter Surgical Shifts Mean Less Training

Fri, 07/12/2013 - 10:24am
Todd Neale

Restricting work shifts for postgraduate year one residents to 16 hours appears to have reduced the operative experience of general surgery interns, researchers found.

Compared with the four academic years before the change, the year immediately following the restriction saw significant declines in total operative cases (by 25.8%), major cases (by 31.8 percent), and first-assistant cases (by 46.3 percent) performed by the interns (P≤0.008 for all), according to Christian de Virgilio, MD, of Harbor-University of California Los Angeles Medical Center, and colleagues.

The drops were seen across most types of surgery, the researchers reported online in JAMA Surgery.

"If the 16-hour shift were to be extended to all postgraduate year levels, one can anticipate that additional years of training will be needed to maintain the same operative volume," they wrote, noting that the reduced experience of interns entering postgraduate year two "may have a domino effect on subsequent competence."

"Given that the U.S. healthcare system is already struggling to provide funding for graduate medical education and given the rising costs of medical education for students, such a prolongation of surgical residency training is unlikely to be viewed favorably," they wrote.

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