Impact of resident work-hour restrictions on trauma care

Matthew C Byrnes, Vincent C Narciso, Leah Brantley, Stephen D Helmer, R Stephen Smith
American Journal of Surgery 2006, 191 (3): 338-43

BACKGROUND: In July 2003, the American Council for Graduate Medical Education (ACGME) required residency programs to significantly restrict resident work hours. The effect of these regulations on trauma services has not yet been investigated. The purpose of this study was to evaluate the effect of the ACGME regulations on the care of injured patients and resident education.

METHODS: A 24-question instrument was mailed to a sample of senior trauma surgeons.

RESULTS: Shift work has become significantly more common among trauma residents since July 2003 (14% vs. 53.4%, (P < .001)). Fifty-four percent of respondents believed that trauma education has worsened and 45% believed that patient care has worsened as a result of the work-hour restrictions.

CONCLUSIONS: The ACGME-mandated work-hour restrictions have had a dramatic effect on resident and staff surgeons involved in the care of injured patients. Appropriate methods of responding to these challenges must be developed to improve trauma care and enhance resident education.

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