Division of General Surgery, The University of Western Ontario, London, Ontario, Canada.
J Surg Educ. 2012 Jul-Aug;69(4):487-92. doi: 10.1016/j.jsurg.2011.12.005. Epub 2012 Feb 2.
Work-hour restrictions have had a profound impact on surgical training. However, little is known of how work-hour restrictions may affect the future practice patterns of current surgical residents. The purpose of this study is to compare the anticipated career practice patterns of surgical residents who are training within an environment of work-hour restrictions with the current practice of faculty surgeons.
An electronic survey was sent to all surgery residents and faculty at 2 Canadian university-affiliated medical centers. The survey consisted of questions regarding expected (residents) or current (faculty) practice patterns.
A total of 149 residents and 125 faculty members completed the survey (50.3% and 52.3% response rates, respectively). A greater proportion of males were in the faculty cohort than in the resident group (77.6% vs 62.4%, p = 0.0003). More faculty than residents believed that work-hour restrictions have a negative impact on both residency education (40.8% vs 20.8%, p = 0.008) and preparation for a surgical career (56.8% vs 19.5%, p < 0.0001). Compared with current faculty, residents plan to take less call (p < 0.0003), work fewer days of the week (p < 0.0001), are more likely to limit their duty hours on postcall days (p = 0.009), and take parental leave (p = 0.02) once in practice. Male and female residents differed somewhat in their responses in that more female residents plan to limit their postcall duty hours (55.4% vs 36.5%, p = 0.009) and to take a parental leave (51.8% vs 16.1%, p < 0.0001) compared with their male resident colleagues.
Current surgical residents expect to adopt components of resident work-hour guidelines into their surgical practices after completing their residency. These practice patterns will have surgical workforce implications and might require larger surgical groups and reconsideration of resource allocation.
工作时间限制对外科培训产生了深远的影响。然而，目前对于工作时间限制如何影响当前外科住院医师的未来实践模式知之甚少。本研究的目的是比较在工作时间限制环境中接受培训的外科住院医师和外科教员的预期职业实践模式。
向加拿大 2 所大学附属医院的所有外科住院医师和教员发送电子调查问卷。该调查包括关于预期（住院医师）或当前（教员）实践模式的问题。
共有 149 名住院医师和 125 名教员完成了调查（分别为 50.3%和 52.3%的回复率）。教员组中男性比例高于住院医师组（77.6%比 62.4%，p=0.0003）。与住院医师相比，更多的教员认为工作时间限制对住院医师教育（40.8%比 20.8%，p=0.008）和外科职业准备（56.8%比 19.5%，p<0.0001）都有负面影响。与当前的教员相比，住院医师计划减少值班次数（p<0.0003），每周工作天数减少（p<0.0001），更有可能限制值班后日的工作时间（p=0.009），并在实践中休育儿假（p=0.02）。男性和女性住院医师的回答略有不同，更多的女性住院医师计划限制值班后日的工作时间（55.4%比 36.5%，p=0.009）并休育儿假（51.8%比 16.1%，p<0.0001），而不是他们的男性住院医师同事。
目前的外科住院医师期望在完成住院医师培训后将住院医师工作时间指南的部分内容纳入其外科实践中。这些实践模式将对外科劳动力产生影响，可能需要更大的外科团队，并重新考虑资源分配。
