Here is a link to an interesting editorial on this issue:
http://www.surgicalspotlight.ca/Article.aspx?ver=Summer_2009&f=EditorColumn
The views expressed in the editor's column via the link above, as well as in the article that is quoted, written by Omahen, would suggest that the same length of residency *or even shorter* might be all that is required with more attention to 'deliberate practice'
From Omahen,
http://www.cmaj.ca/content/180/12/1272.full.pdf+html :
"There are 2 ways to deal with reduced
working hours: improve the quality of
the educational experience or increase
the length of training. Studies of human
performance in fields as disparate as
chess, music, sports, surgery and mathematics
have shown that attainment of an
expert level of performance requires
about 10 000 hours of focused practice.1
How long does it take to accrue
10 000 hours of practice? Working 80
hours a week for 48 weeks a year, the
10 000-hour mark is reached in a mere
2.6 years. So what’s all the fuss about
then? There’s a catch in the 10000-hour
rule: practice time must be deliberately
focused on learning a particular skill.2 Ericsson
and colleagues define deliberate
practice as “highly structured activity, the
explicit goal of which is to improve performance.”3
Is learning the main goal of
most of a resident’s daily activities or is
learning merely a byproduct of servicerelated
tasks?
Another number appears in studies
across disciplines: 5 hours.1 From virtuoso
musicians to elite athletes, top performers
spend 4 to 6 hours daily in intensely
focused, deliberate practice.3
Above this level, concentration and
performance levels drop off and diminishing
returns are received from time
invested, a phenomenon known as “effort
constraint.”2
In real life, residency training involves
a mixture of education and service.
Many learning activities, such as
reading, are done outside of working
hours. Suppose a resident is fully engaged
in learning relevant skills 5 hours
a day, 6 days a week: how long until the
magic 10 000 hour mark is attained? Allowing
for 4 weeks of holidays annually,
the answer is about 6.9 years. The neurosurgery
residency I graduated from was 6
years in length, with most residents electing
to take at least 1 extra year of fellowship
training. Coincidence?" (Omahen)
.
