Attitudes of applicants for surgical residency toward work hour limitations

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Introduction: Resident work hour limitations (WHL) is one of the most controversial issues facing teaching hospitals and surgery departments across the United States. At the same time, surgical residency programs are facing increasing challenges to attract the best applicants. We wanted to determine the attitudes of applicants for surgical residency toward WHL and its impact on their decision-making. Methods: Candidates for residency in general surgery at New York University School of Medicine were asked to anonymously complete a survey during their interview day. The survey queried applicants regarding their priorities in ranking surgical programs and their opinions toward WHL. Data was analyzed by ANOVA. Results: The presence or absence of WHL did not affect most candidates’ decision to apply to a particular surgical residency program. For example, only 12% (5/41) of applicants indicated that they specifically avoided applying to programs with reputations for long work-hours. Similarly, only 15% (6/41) of applicants acknowledged that they sought out programs with challenging work-hours. Nevertheless, 70% of candidates viewed WHL as favorable to their future training and indicated that if all other factors were equal, they would choose a program that enforces WHL over one that does not. Only 2% (1/41) of candidates indicated that they would rank a program lower as a result of its enforcement of WHL. When applicants were asked to rank the most likely ways they would spend the leisure time afforded to them by WHL, out of 6 possible choices, “reading in surgery” was the highest ranked choice (mean rank 2.3, p < 0.001). While WHL were viewed favorably, it was ultimately not a high priority factor for most applicants compared to issues such a quality of training, reputation, location, research opportunities, or even benefits packages (Figure, p < 0.001)). Conclusions: Most applicants for surgical residency consider work hour limitations as favorable to their future training and view the extra free time afforded as an opportunity for furthering their education. However, issues such as the quality and reputation of the program take priority when ranking programs.