Objective: To assess the opinions of vascular surgery trainees on the new Accreditation Council for Graduate Medical Education (ACGME) guidelines. Methods: A questionnaire was developed and electronically distributed to trainee members of the Society for Vascular Surgery. Results: Of 238 eligible vascular trainees, 38 (16%) participated. Respondents were predominantly 30 to 35 years of age (47%), male (69%), in 2-year fellowship (73%), and at large academic centers (61%). Trainees report occasionally working while fatigued (63%). Fellows were more likely to report for duty while fatigued (P = .012) than integrated vascular residents. Respondents thought further work-hour restrictions would not improve patient care or training (P < .05) and may not lead to more sleep or improved quality of life. Respondents reported that duty hours should vary by specialty (81%) and allow flexibility in the last years of training (P < .05). Conclusions: Vascular surgery trainees are concerned about further duty-hour restrictions on patient care, education, and training and fatigue mitigation has to be balanced against the need to adequately train vascular surgeons.
JamalMHRousseauMCHannaWCDoiSAMeterissianSSnellL (2011). Effect of the ACGME duty hours restrictions on surgical residents and faculty: a systematic review. Acad Med, 86(1):34–42.
2.
Position of the American College of Surgeons on Restrictions on Resident Work Hours Presented to the Institute of Medicine Consensus Committee. American College of Surgeons Task Force on the 80-hour Work Week. Paper presented at Institute of Medicine Consensus Committee; March4, 2008.
3.
Institute of Medicine (U.S.). JohnsMMEUlmerCWolmanDMCommittee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedules to Improve Patient Safety.. Resident Duty Hours Enhancing Sleep, Supervision, and Safety. Washington, DC: National Academies Press; 2009. http://www.nap.edu/catalog.php?record_id=12508. Accessed August 2011.
4.
IraniJLMelloMMAshleySWWhangEEZinnerMJBreenE (2005). Surgical residents' perceptions of the effects of the ACGME duty hour requirements 1 year after implementation. Surgery, 138(2):246–253.
5.
DroletBCSpallutoLBFischerSA (2010). Residents' perspectives on ACGME regulation of supervision and duty hours—a national survey. N Engl J Med, 363(23):e34.
6.
LeapeLLBerwickDMBatesDW (2002). What practices will most improve safety? Evidence-based medicine meets patient safety. JAMA, 288(4):501–507.
7.
AskenMJRahamDC (1983). Resident performance and sleep deprivation: a review. J Med Educ, 58(5):382–388.
8.
FriedmanRCBiggerJTKornfeldDS (1971). The intern and sleep loss. N Engl J Med, 285(4):201–203.
9.
LeungLBeckerCE (1992). Sleep deprivation and house staff performance. Update 1984-1991. J Occup Med, 34(12):1153–1160.
10.
BrittLDSachdevaAKHealyGBWhalenTVBlairPG (2009). Resident duty hours in surgery for ensuring patient safety, providing optimum resident education and training, and promoting resident well-being: a response from the American College of Surgeons to the Report of the Institute of Medicine, “Resident Duty Hours: Enhancing Sleep, Supervision, and Safety”. Surgery, 146(3):398–409.
11.
KairysJCMcGuireKCrawfordAGYeoCJ (2008). Cumulative operative experience is decreasing during general surgery residency: a worrisome trend for surgical trainees?. J Am Coll Surg, 206(5):804–811.discussion 811-803
12.
UnderwoodWBoydAJFletcherKELypsonML (2004). Viewpoints from generation X: a survey of candidate and associate viewpoints on resident duty-hour regulations. J Am Coll Surg, 198(6):989–993.
13.
NascaTJDaySHAmisESJr (2010). The new recommendations on duty hours from the ACGME Task Force. N Engl J Med, 363(2):e3.
14.
FischerJE (2004). Continuity of care: a casualty of the 80-hour work week. Acad Med, 79(5):381–383.
15.
LiebermanJDOlenwineJAFinleyWNicholasGG (2005). Residency reform: anticipated effects of ACGME guidelines on general surgery and internal medicine residency programs. Curr Surg, 62(2):231–236.
16.
SinghHThomasEJPetersenLAStuddertDM (2007). Medical errors involving trainees: a study of closed malpractice claims from 5 insurers. Arch Intern Med, 167(19):2030–2036.
17.
EscobarMAMcCulloughLB (2006). Responsibly managing ethical challenges of residency training: a guide for surgery residents, educators, and residency program leaders. J Am Coll Surg, 202(3):531–535.
18.
GelfandDVPodnosYDCarmichaelJCSaltzmanDJWilsonSEWilliamsRA (2004). Effect of the 80-hour workweek on resident burnout. Arch Surg, 139(9):933–938.discussion 938-940
19.
AntielRMThompsonSMReedDA (2010). ACGME duty-hour recommendations—a national survey of residency program directors. N Engl J Med, 363(8):e12.
20.
BormanKRFuhrmanGM (2009). “Resident Duty Hours: Enhancing Sleep, Supervision, and Safety”: response of the Association of Program Directors in Surgery to the December 2008 Report of the Institute of Medicine. Surgery, 146(3):420–427.
21.
CuretMJ (2008). Resident work hour restrictions: where are we now?. J Am Coll Surg, 207(5):767–776.
22.
VolppKGRosenAKRosenbaumPR (2007). Mortality among hospitalized Medicare beneficiaries in the first 2 years following ACGME resident duty hour reform. JAMA, 298(9):975–983.
23.
VolppKGRosenAKRosenbaumPR (2007). Mortality among patients in VA hospitals in the first 2 years following ACGME resident duty hour reform. JAMA, 298(9):984–992.
24.
ShettyKDBhattacharyaJ (2007). Changes in hospital mortality associated with residency work-hour regulations. Ann Intern Med, 147(2):73–80.
25.
SalimATeixeiraPGChanL (2007). Impact of the 80-hour workweek on patient care at a level I trauma center. Arch Surg, 142(8):708–712.discussion 712-704
26.
PouloseBKRayWAArbogastPG (2005). Resident work hour limits and patient safety. Ann Surg, 241(6):847–856.discussion 856-860
27.
PetersenLABrennanTAO’NeilACCookEFLeeTH (1994). Does housestaff discontinuity of care increase the risk for preventable adverse events?. Ann Intern Med, 121(11):866–872.
28.
DebasHTBassBLBrennanMF (2005). American Surgical Association Blue Ribbon Committee Report on Surgical Education: 2004. Ann Surg, 241(1):1–8.
29.
MoalemJSalzmanPRuanDT (2009). Should all duty hours be the same? Results of a national survey of surgical trainees. J Am Coll Surg, 209(1):47–54, 54 e1–e2.
