From Our 2010 Archives

Fewer Hours for Medical Residents May Backfire

TUESDAY, June 22 (HealthDay News) -- A 50-hour workweek limit for surgical residents in Switzerland may negatively affect surgical training and quality of patient care, suggests a new study.

The law, introduced in 2005, limits hospital-based residents and consultants to 14 hours per day of work, including breaks. They must be given 11 or more consecutive hours per day of rest. The rules have generated heated debate among surgeons.

In this study, researchers analyzed responses to surveys filled out in 2006 by 221 residents and 184 consultants in 52 surgical departments. Among the findings:

  • Residents worked an average of 55 hours a week. Residents were more satisfied with the new workweek limits (average score, 52 out of 100) than consultants (average score, 41).
  • Only 8.1% of residents and 4.9% of consultants believed the new limits benefited surgical training, while 62.8% of residents and 77.2% of consultants said there was a negative effect on surgical training.
  • The new rules lowered the quality of patient care, according to 43% of residents and 70.1% of consultants, and also had a negative effect on operating time (76.9% of residents and 73.4% of consultants) and operating room experience (73.8% of residents and 84.8% of consultants).
  • Quality of life for residents improved, according to 58.4% of residents and 81.5% of consultants.

"Both groups reported increased chances for residents to maintain a social network and to rest," wrote Dr. Adrian Businger, of University Hospital Basel, and colleagues. "However, improved quality of life seems to be a passive consequence of the new regulations in light of the clearly negative effect on surgical education and on patient care. Residents were ambivalent about the consequences of the workweek limitation on surgical training. Residents and consultants believed that residents' training and quality of education had decreased. All aspects of surgical training were assessed as negatively affected."

The findings suggest the workweek limitations are a failure, the authors said. They suggest that resident paperwork be reduced or reassigned and said surgical residents must study while off-duty.

The study is published in the June issue of the journal Archives of Surgery.

-- Robert Preidt

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SOURCE: JAMA/Archives journals, news release, June 21, 2010