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Original Article |

Surgical Training, Duty-Hour Restrictions, and Implications for Meeting the Accreditation Council for Graduate Medical Education Core Competencies:  Views of Surgical Interns Compared With Program Directors

Ryan M. Antiel, MD, MA; Kyle J. Van Arendonk, MD; Darcy A. Reed, MD, MPH; Kyla P. Terhune, MD; John L. Tarpley, MD; John R. Porterfield, MD, MPH; Daniel E. Hall, MD, MDiv; David L. Joyce, MD; Sean C. Wightman, MD; Karen D. Horvath, MD; Stephanie F. Heller, MD; David R. Farley, MD
Arch Surg. 2012;147(6):536-541. doi:10.1001/archsurg.2012.89.
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Objective  To describe the perspectives of surgical interns regarding the implications of the new Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulations for their training.

Design  We compared responses of interns and surgery program directors on a survey about the proposed ACGME mandates.

Setting  Eleven general surgery residency programs.

Participants  Two hundred fifteen interns who were administered the survey during the summer of 2011 and a previously surveyed national sample of 134 surgery program directors.

Main Outcome Measures  Perceptions of the implications of the new duty-hour restrictions on various aspects of surgical training, including the 6 ACGME core competencies of graduate medical education, measured using 3-point scales (increase, no change, or decrease).

Results  Of 215 eligible surgical interns, 179 (83.3%) completed the survey. Most interns believed that the new duty-hour regulations will decrease continuity with patients (80.3%), time spent operating (67.4%), and coordination of patient care (57.6%), while approximately half believed that the changes will decrease their acquisition of medical knowledge (48.0%), development of surgical skills (52.8%), and overall educational experience (51.1%). Most believed that the changes will improve or will not alter other aspects of training, and 61.5% believed that the new standards will decrease resident fatigue. Surgical interns were significantly less pessimistic than surgery program directors regarding the implications of the new duty-hour restrictions on all aspects of surgical training (P < .05 for all comparisons).

Conclusions  Although less pessimistic than program directors, interns beginning their training under the new paradigm of duty-hour restrictions have significant concerns about the effect of these regulations on the quality of their training.

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Figure. Surgical interns' views on how the new Accreditation Council for Graduate Medical Education duty-hour regulations will affect aspects of graduate medical education.

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