The impact of the 80-hour workweek on pediatric surgical training: an Association of Pediatric Surgery Program Directors–sponsored study

Abstract

Background/Purpose The aim of this study was to determine the preliminary impact of work hour regulations on pediatric surgical training. Methods An anonymous survey was sent to all program directors (PDs) and fellows to identify changes in pediatric surgery fellowship programs. Results Ninety-three percent of programs and 87% of PDs responded. Thirty programs hired additional personnel, including nurse practitioners, physician assistants, and fellows outside the training program. Thirteen programs reported increased attending coverage. The daily composition of the surgical team has changed, with postcall fellows and residents leaving in the morning. Residents and fellows also take call less frequently. More than 50% of PDs felt that quality of care had declined and three quarters of respondents felt that continuity of care was worse. Half of the respondents feared missed educational opportunities. However, half of the fellows felt more rested, 61% reported more family time, and 22% reported increased social time. In contrast, no PDs perceived life-style improvements. Conclusions The work hour regulations have resulted in fundamental changes in pediatric surgical training. Ongoing assessment is needed to prioritize quality of care, improve continuity of care, and track changes in operative, clinical, and didactic experiences of the trainees. The added impact of these changes on the time spent available for commitment to teaching by the faculty should be assessed.