The resident 80-hour work week: how has it affected surgical specialties?

OBJECTIVES: To identify strategies employed by surgical departments to address recently implemented resident duty hour regulations, and to assess resident and faculty acceptance of these changes.
METHODS: Attendees to the 2003 Residency Program Coordinator/Administrator Workshop for sub-specialties (Denver, CO) were surveyed.
RESULTS: The study population included 46 respondents spanning 9 surgical sub-specialties. Forty-eight percent of programs instituted at least 1 administrative change specifically to comply with duty hour regulations. The most commonly employed strategies were the hiring of nurse practitioners or physician assistants (30%) and the use of Internet-based software to track resident duty hours (30%). Other changes included giving call responsibilities to residents on research rotations (19%), institution of home-call (13%), and assignment of a night-float resident (11%). Perceptions of program coordinators indicated that junior residents and junior faculty accepted changes better than did senior residents and senior faculty (P=.025).
CONCLUSION: The resident 80-hour work week is a major health care policy change that has required academic sub-specialty departments to make significant alterations in their administrative structure. Further study is necessary to determine how these changes affect both quality of training and patient care in the short and long term.