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Study: surgical residents less tired, less prepared

Orthopedic surgeons-in-training face many challenges when trying to gain the on-the-job skills necessary to become an orthopedic surgeon. Rules limiting the number of hours surgeons-in-training can work per week were designed to reduce their fatigue and resulting surgical errors.

A new study shows that while the work hour rules have been beneficial in many ways, many surgeons feel less prepared and less confident in their orthopedic skills. The study found that the limited work hours did not result in more sleep for surgeons but it did reduce the amount of surgeons feeling fatigued.

During the study, researchers issued surveys to 216 residents at the Harvard Orthopedic Combined Residency Program between 2003 and 2009. In 2009, orthopedic surgeons-in-training reported working 66 hours a week compared to 75 hours in 2003. Despite the decrease in hours worked, the surgeons did not report getting any more sleep, with doctors reporting an average of 5 hours a sleep per night.

After the new work-hour regulations were announced, residents reported feeling less tired and some reported that fatigue still had a negative impact on patient care and safety. Researchers and patient safety advocates assumed the work-hour limits would result in more sleep for residents but that does not seem to be the case.

While residents did not report more sleep, many stated that they did feel less stressed and less fatigued after the work-hour limits went into effect. Researchers noted that the work-hour limits are beneficial since they have helped residents reduce stress and improve their well-being.

On the other hand, residents also reported that while they feel less stressed and tired, they do not feel as confident in their education due to the decrease in hands-on experience in orthopedic surgery. Residents who took the survey said that the work limits may have a negative impact on their education.

The study found that surgeons-in-training did not feel as prepared to make clinical decisions and were not as confident to perform the range of skills expected of them. Researchers said that while this is concerning, it does a good job showing the impact of limiting work hours for residents and why it may not be beneficial to continue limiting work hours for surgical residents.

Source: Chicago Tribune, "Young doctors: fewer hours means they're less tired, less prepared," Elaine Lies, Nov. 4, 2012

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