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Shorter shifts mean big cuts in interns' operating experience

NEWS IN BRIEF — Posted July 22, 2013

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The duty-hour regulations imposed in July 2011 are resulting in surgical interns who have much less time in the operating room compared with their predecessors, said a JAMA Surgery study published online July 10.

In an effort to address the potential safety impact of sleep deprivation, the Accreditation Council for Graduate Medical Education said interns should not work shifts longer than 16 hours. In the first year since that new rule took effect, surgery interns saw 26% fewer operative cases of any kind than did interns from 2007 to 2010. The interns also saw 32% fewer major cases and a 46% drop in first-assistance cases, the study found (link).

Researchers examined the caseloads of 52 surgical interns from 2011-2012 who had to comply with the 16-hour rule and compared those with 197 interns from prior years. They found statistically significant drops in surgical cases involving the abdomen, head and neck, laparoscopy, pediatrics, thoracic and soft tissue/breast surgeries. Surgeons in training typically do four more years of residency following their intern year. The study's authors said the shortfall in operative experience in the first postgraduate year could have a ripple effect on later training.

“Although it is convenient to believe that the decrease in operative volume is unlikely to be catastrophic in terms of overall surgery resident training, it will clearly create a new pool of less-experienced residents at the second-year level,” the study said.

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