OBJECTIVE: To investigate the reason for noncompliance with the work-hour regulation by surgical residents.
DESIGN: Nationwide anonymous survey (November 1, 2007, to March 1, 2008).
SETTING: Academic center.
PARTICIPANTS: Surgical residents throughout the United States.
MAIN OUTCOME MEASURES: Incidence of noncompliance remains high and reasons for noncompliance are multifactorial.
RESULTS: The first 141 questionnaires returned were included in this analysis. Responders consisted of postgraduate year (PGY)-1 (32.6%), PGY-2 (19.1%), PGY-3 (17.7%), PGY-4 (13.5%), and PGY-5 (17.0%) surgical residents. Many residents were categorical (79.4%), male (61.7%), and married (53.2%). Ninety-eight percent of residents were aware of the work-hour regulation, with 72.1% of residents in favor of it. However, noncompliance with the work-hour regulation was 64.6%, with 21.1% of residents working more than 90 h/wk (average, 86.6 h/wk). The most problematic regulations to follow were "at least 10 hours of rest between duty hours" (36.9%), "24-hour limit of continuous care plus 6 additional hours for continuity of care and educational objectives" (26.1%), and "80-hour work limit over 4 weeks" (22.7%). Education and continuity in patient care were the main reasons associated with noncompliance. Noncompliance was highest in trauma (25.2%) and vascular surgery (16.3%) residents. In addition, 65.2% of the attending physicians do not agree with implementing work-hour regulation standards in the surgical faculty.
CONCLUSIONS: The survey demonstrates that noncompliance with the work-hour regulation is prevalent. The reasons for noncompliance are multifactorial. These findings will help restructure training programs in the efforts to increase compliance with the work-hour regulation.
}, year = {2011}, journal = {Arch Surg}, volume = {146}, pages = {175-8}, month = {02/2011}, issn = {1538-3644}, doi = {10.1001/archsurg.2010.337}, language = {eng}, }