Results of a National Neurosurgery Resident Survey on Duty Hour Regulations

BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) duty hour standards that began July 2011 will further limit resident duty hours. OBJECTIVE: To survey neurosurgery residents in the United States on duty hour violations under the current system and the predicted effects on education and patient safety of the new regulations. METHODS: Surveys were mailed to every neurosurgery training program in the United States and Puerto Rico. Program directors and coordinators were asked to distribute surveys to their residents. RESULTS: Three hundred seventy-seven neurosurgery residents mailed surveys back to the study center (34% response rate). More than one-third of respondents reported violating the 80-hour rule occasionally or frequently (36%). Thirty-one residents (8%) reported having been involved in a motor vehicle collision or life-threatening event and 20 (6%) reported having made a medical error resulting in patient harm after an extended shift. Eighty-three percent disagreed with the 16-hour proposed regulation for postgraduate year 1. The majority of respondents thought that the new standards will have a negative or strongly negative effect on their residency training (72%). CONCLUSION: This national duty hour survey of neurosurgical residents reveals considerable concern over the new ACGME proposed standards. The majority of respondents believe that the new standards will have a negative effect on their residency training. Furthermore, this survey indicates an overwhelming negative attitude toward mandated duty hour regulations among neurosurgical residents. Duty hour violations reported in this survey may be a more honest depiction of true violations than previous surveys and are higher than expected.