TY - JOUR T1 - PErsistent noncompliance with the work-hour regulation AU - Tabrizian P, Rajhbeharrysingh U, Khaitov S, Divino CM Y1 - 2011/02/01 N1 - 10.1001/archsurg.2010.337 JO - Archives of Surgery SP - 175 EP - 178 VL - 146 IS - 2 N2 - Objective  To investigate the reason for noncompliance with the work-hour regulation by surgical residents.Design  Nationwide anonymous survey (November 1, 2007, to March 1, 2008).Setting  Academic center.Participants  Surgical residents throughout the United States.Main Outcome Measures  Incidence of noncompliance remains high and reasons for noncompliance are multifactorial.Results  The first 141 questionnaires returned were included in this analysis. Responders consisted of postgraduate year (PGY)–1 (32.6%), PGY-2 (19.1%), PGY-3 (17.7%), PGY-4 (13.5%), and PGY-5 (17.0%) surgical residents. Many residents were categorical (79.4%), male (61.7%), and married (53.2%). Ninety-eight percent of residents were aware of the work-hour regulation, with 72.1% of residents in favor of it. However, noncompliance with the work-hour regulation was 64.6%, with 21.1% of residents working more than 90 h/wk (average, 86.6 h/wk). The most problematic regulations to follow were “at least 10 hours of rest between duty hours” (36.9%), “24-hour limit of continuous care plus 6 additional hours for continuity of care and educational objectives” (26.1%), and “80-hour work limit over 4 weeks” (22.7%). Education and continuity in patient care were the main reasons associated with noncompliance. Noncompliance was highest in trauma (25.2%) and vascular surgery (16.3%) residents. In addition, 65.2% of the attending physicians do not agree with implementing work-hour regulation standards in the surgical faculty.Conclusions  The survey demonstrates that noncompliance with the work-hour regulation is prevalent. The reasons for noncompliance are multifactorial. These findings will help restructure training programs in the efforts to increase compliance with the work-hour regulation. SN - 0004-0010 M3 - doi: 10.1001/archsurg.2010.337 UR - http://dx.doi.org/10.1001/archsurg.2010.337 ER -