Whang Edward E, Mello Michelle M, Ashley Stanley W, Zinner Michael J
Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Ann Surg. 2003 Apr;237(4):449-55. doi: 10.1097/01.SLA.0000059966.07463.19.
To determine the impact of work hour limitations imposed by the 405 (Bell) Regulations as perceived by general surgery residents in New York State.
New Accreditation Council for Graduate Medical Education (ACGME) requirements on resident duty hours are scheduled to undergo nationwide implementation in July 2003. State regulations stipulating similar resident work hour limitations have already been enacted in New York.
A statewide survey of residents enrolled in general surgery residencies in New York was administered.
Most respondents reported general compliance with 405 Regulations in their residency programs, a finding corroborated by reported work hours and call schedules. Whereas a majority of residents reported improved quality of life as a result of the work hour limitations, a substantial portion reported negative impacts on surgical training and quality and continuity of patient care. Negative perceptions of the impact of duty hour restrictions were more prevalent among senior residents and residents at academic medical centers than among junior residents and residents at community hospitals.
Implementation of resident work hour limitations in general surgery residencies may have negative consequences for patient care and resident education. As surgical residency programs develop strategies for complying with ACGME requirements, these negative consequences must be addressed.
确定纽约州普通外科住院医师所感受到的405（贝尔）法规对工作时间限制的影响。
研究生医学教育认证委员会（ACGME）对住院医师值班时间的要求计划于2003年7月在全国范围内实施。纽约州已经颁布了规定类似住院医师工作时间限制的法规。
对纽约州普通外科住院医师项目中的住院医师进行了一项全州范围的调查。
大多数受访者表示他们所在的住院医师培训项目总体上遵守405法规，报告的工作时间和值班安排证实了这一发现。虽然大多数住院医师表示工作时间限制使生活质量得到了改善，但相当一部分人报告称这对手术培训以及患者护理的质量和连续性产生了负面影响。与初级住院医师和社区医院的住院医师相比，高级住院医师和学术医疗中心的住院医师对值班时间限制影响的负面看法更为普遍。
普通外科住院医师工作时间限制的实施可能会对患者护理和住院医师教育产生负面影响。随着外科住院医师培训项目制定符合ACGME要求的策略，必须解决这些负面后果。
