Adrian Businger1, Ulrich Guller, Daniel Oertli. 1. Department of General Surgery and Surgical Research, University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland.
Abstract
HYPOTHESIS: The 50-hour workweek limitation for surgical residents in Switzerland has a major effect on surgical training, resident quality of life, and patient care. DESIGN: Survey study. SETTING: Residencies in Switzerland. PARTICIPANTS: Surgical residents and surgical consultants. MAIN OUTCOME MEASURES: An anonymous survey was conducted in Switzerland. Of 93 surgical departments contacted, 52 (55.9%) responded; of their 281 surgical residents and 337 surgical consultants, 405 (65.5%) returned a completed survey. RESULTS: Residents and consultants indicated a negative effect of the 50-hour workweek limitation on surgical training (62.8% and 77.2%, respectively) and on quality of patient care (43.0% and 70.1%, respectively) (P<.001 for both). Most residents and consultants reported that operative time (76.9% and 73.4%, respectively) and overall operating room experience (73.8% and 84.8%, respectively) were negatively affected by the work hour limitation. Only 8.1% of residents and 4.9% of consultants perceived the work hour limitation as beneficial to surgical training. Conversely, 58.4% of residents and 81.5% of consultants considered that residents' quality of life had improved (P<.001). CONCLUSIONS: Most surgical residents and surgical consultants perceive the work hour limitation as having a negative effect on surgical training and on the quality of patient care. Despite somewhat improved resident quality of life, the work hour limitation for surgical residencies in Switzerland appears to be a failure.
HYPOTHESIS: The 50-hour workweek limitation for surgical residents in Switzerland has a major effect on surgical training, resident quality of life, and patient care. DESIGN: Survey study. SETTING: Residencies in Switzerland. PARTICIPANTS: Surgical residents and surgical consultants. MAIN OUTCOME MEASURES: An anonymous survey was conducted in Switzerland. Of 93 surgical departments contacted, 52 (55.9%) responded; of their 281 surgical residents and 337 surgical consultants, 405 (65.5%) returned a completed survey. RESULTS: Residents and consultants indicated a negative effect of the 50-hour workweek limitation on surgical training (62.8% and 77.2%, respectively) and on quality of patient care (43.0% and 70.1%, respectively) (P<.001 for both). Most residents and consultants reported that operative time (76.9% and 73.4%, respectively) and overall operating room experience (73.8% and 84.8%, respectively) were negatively affected by the work hour limitation. Only 8.1% of residents and 4.9% of consultants perceived the work hour limitation as beneficial to surgical training. Conversely, 58.4% of residents and 81.5% of consultants considered that residents' quality of life had improved (P<.001). CONCLUSIONS: Most surgical residents and surgical consultants perceive the work hour limitation as having a negative effect on surgical training and on the quality of patient care. Despite somewhat improved resident quality of life, the work hour limitation for surgical residencies in Switzerland appears to be a failure.
Authors: Simon Schimmack; Ulf Hinz; Andreas Wagner; Thomas Schmidt; Hendrik Strothmann; Markus W Büchler; Hubertus Schmitz-Winnenthal Journal: Health Econ Rev Date: 2014-09-16