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Workweek Cuts a Concern for Neurosurgery Residents

Last Updated: May 18, 2009.

Many involved in the training of neurosurgeons express concerns that further reductions in residents' weekly work hours would threaten the quality of their education and patient care, according to two studies in the May Journal of Neurosurgery.

MONDAY, May 18 (HealthDay News) -- Many involved in the training of neurosurgeons express concern that further reductions in residents' weekly work hours would threaten the quality of their education and patient care, according to two studies in the May Journal of Neurosurgery.

Jay Jagannathan, M.D., of the University of Virginia Health Sciences Center in Charlottesville, and colleagues write that the Accreditation Council for Graduate Medical Education established an 80-hour workweek for residents in 2003, and some experts have broached the idea of a 56-hour week for residents. In a survey of 110 neurosurgical program directors and 122 neurosurgical chief residents, the researchers found that nearly all felt that the 80-hour week compromised resident training (96 percent) and reduced residents' surgical experience (98 percent). Most also felt that the 80-hour week threatened patient safety. A drop to 56 hours would further impair residents' training, reported all of the directors and 98 percent of the chief residents.

In the other study, M. Sean Grady, M.D., of the University of Pennsylvania School of Medicine in Philadelphia, and colleagues write that more significant reductions in residents' duty hours will result in the potential for significant harm to members of the public.

"Clearly, further reduction in duty hours will decrease the number of supervised clinical experiences for each resident, including the number of emergencies that each resident evaluates and manages. Neurosurgery is becoming more complex, and the amount of knowledge and experience required of a neurosurgeon is actually increasing, not decreasing," Grady and colleagues write. "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."

Abstract - Jagannathan
Full Text - Jagannathan
Abstract - Grady
Full Text - Grady


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