U.S. Surgeons Receiving Less Training and Experience
New study finds regulation meant to improve healthcare is costing new surgeons hundreds of hours of training
Regulations that limit the number of hours medical residents can work in a week may be impeding young doctors from getting the experience they need to treat patients, a new study suggests.
The study from the University of Mississippi Medical Center found residents are performing more than 520 fewer procedures annually than they did prior to 2003, when the Accreditation Council for Graduate Medical Education, which sets standards for medical residency programs in the U.S., began restricting residents from working more than 80 hours a week.
Before the regulations went into effect, residents regularly spent more than 100 hours a week at the hospital, often working several days straight without sleep.
The regulations were designed to give residents more time for rest and study, to improve training, decrease medical errors and reduce fatigue. But many in the medical field are now asking whether duty-hour restrictions are preventing the doctors from getting the medical experience they need.
They note that surgeons today are starting their careers with hundreds of hours less training than they did before the new rules went into effect.
“According to our study, our residents are not getting as much time in the operating room observing or assisting more experienced surgeons doing these complex operations,” said Dr. Marc Mitchell, chairman of the Department of Surgery at UMMC.
“I just think less exposure, less experience translates into less confidence and less ability,” Dr. Winston Capel, who practices neurosurgery in Madison, Miss., told FoxNews.com.
Dr. Jane Orient, executive director of the Association of American Physicans and Surgeons, says less time at the hospital results in less experience for residents. She hopes the UMMC study helps others to consider that introducing duty-hour restrictions may have been a mistake.
“I think the change was instituted with good intentions, thinking, ‘Well people won’t make as many mistakes if they’re not as tired,’” Orient told FoxNews.com. “But people, when they get out of their residency, will make more mistakes because they’ve had less experience.”
Dr. Laura Vick, who is just a few weeks away from completing her residency in general surgery at UMMC, says the restrictions have both good and bad qualities. She said she spends more time at home with her family, gets more rest, and spends less time doing menial tasks that other lower-level employees at the hospital can do.
“But on the flip-side of that, you do have the downside of not being in the OR [operating room] a lot of times,” Vick said, referring to the operating room.
She said she has been forced to leave the OR in the middle of several procedures because she was at the end of her work hours, and she worries that those missed learning opportunities will affect her performance in the future.
But others say the benefits of duty-hour restrictions far outweigh the costs, and actually result in better overall healthcare.
Dr. Shirley Schlessinger, chairwoman of the UMMC Department of Medicine, said she believes the hundred-plus hour workweeks she and her colleagues went through didn’t always result in the best possible care for patients. She remembers several specific cases where significant mistakes in medical treatment occurred because the physicians hadn’t slept for days.
“I can’t help but think, even though we don’t have direct evidence, that it is very likely that the care you’re getting from your physician is better care, more thoughtful care, more skilled, stable hands that are doing your surgery when you have physicians that are not exhausted,” Schlessinger said.
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