A recent Journal of the American College of Surgeons study found that the recently implemented work hour restrictions for resident physicians have not had the desired effect of lowering postoperative complication rates in several common surgical specialties.
Here are four key notes:
1. Researchers found no significant difference in patient outcomes between one year before and two years after the 2011 resident duty hour reform, based on patient data obtained from the American College of Surgeons National Surgical Quality Improvement Program.
2. On July 1, 2011, the Accreditation Council for Graduate Medical Education made the first changes to resident duty hours since its 2003 major reform, which limit first-year residents to working at most 16 hours continuously, as well as mandate at least 14 hours off work after a 24-hour shift. Additionally, residents working 24-hour shifts may spend no more than four hours (instead of the former six hours) in transferring patients.
3. Coauthor Clifford Ko, MD, MS, MSHS, FACS, a professor of surgery at the University of California Los Angeles, said the study shows that patient outcomes were not worse with less restrictive resident duty hours.
4. Researchers call for additional work and randomized clinical trials on how to best structure resident hours.
"This study adds to the body of medical literature showing no strong association between resident duty hour reform and change in postoperative outcomes," said Lead Investigator Ravi Rajaram, MD, MSc, a Resident Clinical Scholar at the American College of Surgeons and a fellow with the Surgical Outcomes and Quality Improvement Center, Northwestern University Feinberg School of Medicine in Chicago. "Our finding suggests the ACGME reform is not meeting its goal of improved patient safety in surgery."