Some surgical residency programs ask for a cap of 88 hours per week (averaged over 4 weeks) vs 80 for their residents. This is the case with neurosurgery programs (obviously) and some CT surgery programs (I think).
Do these extra hours really make that much of a difference in the long run?
Here are some links related to this topic:
https://www.acgme.org/acgmeweb/Portals/0/PDFs/jgme-11-00-29-37.pdf
http://neurosurgery.ucla.edu/body.cfm?id=989
http://www.medscape.com/viewarticle/775133
(Interestingly, the Vanderbilt neurosurgery program does not ask for the extra 8 hrs).
http://www.mc.vanderbilt.edu/root/vumc.php?site=neurosurgery&doc=16650
Any feedback from med students, residents, and attendings would be greatly appreciated.
Does an extra 8 hours/week matter? Yes. But, it matters far, far, FAR less than getting rid of the intern rules that they put into place. You are increasing your hours by 10%. I've said it before, you are the sum total of your experiences. More experiences = better educated. What this doesn't encapsulate is what you are doing with your extra hours. If you are doing 8 hours of extra discharge summaries and other paper work, then it is useless. That is pure service (after you learn to do it, and do it well). But, if you are simply allowed to be in the hospital, seeing consults, going to clinic, being in the OR, running the floor, etc, yes, you will be better educated.
If the surgery residencies want different rules, let them create their own accrediting organization in which they can do whatever they want 88, 95, or an even 100.
I'm not sure why you need a different accreditation organization. Graduate Medical Education is a very large catch all. I don't know why you need a uniform standard for every specialty that is under their banner. Why create a duplicate institution for some minor differences?
Maybe that's what needs to happen.
http://www.ncbi.nlm.nih.gov/m/pubmed/23843028/
From the study above:
CONCLUSIONS AND RELEVANCE: The 16-hour work limit for interns, implemented in July 2011, is associated with a significant decrease in categorical intern operative experience. If the 16-hour shift were to be extended to all postgraduate year levels, one can anticipate that additional years of training will be needed to maintain the same operative volume
There is a logic jump here that I don't think is supported. They changed two variables and then assume that they do not influence each other at all. Just because the interns run out of time to go to the OR, doesn't mean that the cases are just going to disappear and go uncovered. Things would be worse, but not for the reasons they supply.
I didn't think categorical surgical interns got any operative experience. Not surprised they're willing to increase the number of residency years to turn the screws on the younger generation.
Our two interns last year... 85 and 48 lines, 22 and 24 access cases, 1 and 0 major open cases, 4 and 4 endo cases. And, that isn't including the 8 months of general surgery that they do as interns. Operative experience as an intern is vastly over rated. Getting into the OR early is important. Being comfortable with the basics, how the room functions, how the hybrid table works, how the flouroscopy works, who the circulators, scrubs, rad techs, etc are is all important. Actually learning how to operate is not the point. The purpose of being a surgical intern is learning how to function at a high level in the hospital. That is the foundation on which you can build a surgical (or medical for that matter) education. I have to be able to depend on them when they put in a line, see a consult, discharge patients, etc. If you don't get that stuff cold before second year, things will be miserable, for everyone.
I bet integrated programs would become much more prominent. No one wants to do 6-7 years of GS (7-9 with research time) + 2-3 of specialization. I just talked to a surgical attending this cycle who said they're seriously considering extending their GS residency by one year already. I mean common, really??
@cyberdyne101 8 hours a week means an extra 416 hours per year. This is probably significant extra operative time.
I'm not sure where your numbers are from. GS is 5 years (4 with ESP). Research time balloons that to either 6 or 7. Fellowships run 1-3 years with the average being under 2 years.
That's seriously ridiculous if that is true. I believe Plastics is now turning over to a model in which all programs will become integrated, and someone I forget who though, was saying that it's becoming more and more common for those in Ortho/Neurosurg/Urology/ENT(?) to do less and less General Surgery years/months and just go straight to their specialty, due to their use and abuse by General Surgery programs.
There are more and more integrated programs, but it is unlikely to become completely integrated. There is always a need for post GS fellowships. Also, most, if not all surgical sub-specialties have a required number of GS months that is static. That isn't something that changes over time. There may be rule changes that affect everyone every couple of years, but it isn't like programs just pick and choose.
