Department of Surgery, University of North Dakota, School of Medicine and Health Sciences, Grand Forks,North Dakota 58203, USA.
J Surg Educ. 2010 Nov-Dec;67(6):376-80. doi: 10.1016/j.jsurg.2010.07.008. Epub 2010 Nov 5.
Since 2003, compliance with Accreditation Council on Graduate Medical Education (ACGME) work hours regulations has been required for United States residency training programs. Further work hours restrictions have been proposed by the Institute of Medicine (IOM). This study examines General Surgery residents' views of current work hours restrictions and proposed changes by the IOM.
An anonymous multiple-choice survey regarding work hours regulations was distributed to all US General Surgery residency program directors in 2009. Responses were compiled via an on-line survey program. Statistical analysis was performed in aggregate and by junior and senior resident responses.
Nine hundred sixty-five (13.1%) general surgery residents responded. Responses demonstrated that 25% of surgery residents underreported work hours, with statistically significant differences between junior (22%) and senior residents (27%), p = 0.03. Sixteen percent of residents indicated they were instructed to report their work hours inaccurately, while 8% of residents advised junior or coresidents to report their work hours inaccurately. Sixty-five percent felt that other residents underreport their work hours. Junior residents (34%) were more in favor of increased work hours regulations than senior residents (17%; p < 0.001). The majority (52%) have underreported work hours to take care of a sick patient or perform surgery. Seventy-six percent are aware of the recent IOM recommendations for further work hours restrictions, of whom the majority felt that the IOM recommendations would make surgical training worse.
General surgery resident physicians in the US do not always record their work hours accurately and many have concerns about further work hour restrictions. The majority admitted underreporting work hours to care for a sick patient. Most US surgical residents feel further work hour restrictions would be detrimental to their training. Current work hours restrictions force surgery residents to underreport their work hours to perform the activities that they feel are necessary for their surgical training.
自 2003 年以来，美国住院医师培训计划必须遵守研究生医学教育认证委员会（ACGME）的工作时间规定。医学研究所（IOM）进一步提出了工作时间限制的建议。本研究考察了普通外科住院医师对当前工作时间限制和 IOM 提出的变更的看法。
2009 年，向所有美国普通外科住院医师培训计划主任分发了一份关于工作时间规定的匿名多项选择调查。通过在线调查程序汇总答复。对初级和高级住院医师的答复进行了汇总和统计分析。
共有 965 名（13.1％）普通外科住院医师做出了回应。答复表明，有 25％的外科住院医师少报了工作时间，初级（22％）和高级住院医师之间存在统计学差异（p = 0.03）。有 16％的住院医师表示他们被指示不准确地报告工作时间，而有 8％的住院医师建议初级或核心住院医师不准确地报告工作时间。有 65％的人认为其他住院医师少报了工作时间。初级住院医师（34％）比高级住院医师（17％；p <0.001）更赞成增加工作时间规定。大多数（52％）为了照顾生病的病人或进行手术而少报了工作时间。有 76％的人了解 IOM 关于进一步工作时间限制的最新建议，其中大多数人认为 IOM 的建议会使外科培训恶化。
美国普通外科住院医师医师并不总是准确记录工作时间，并且许多人对进一步的工作时间限制表示担忧。大多数人承认少报工作时间是为了照顾生病的病人。大多数美国外科住院医师认为进一步的工作时间限制对他们的培训不利。当前的工作时间限制迫使外科住院医师少报工作时间，以开展他们认为对其外科培训必不可少的活动。
