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residents work hour restriction

Marc Beltempo, Karin Clement, Guy Lacroix, Sylvie Bélanger, Anne-Sophie Julien, Bruno Piedboeuf
OBJECTIVE:  This article assesses the effect of reducing consecutive hours worked by residents from 24 to 16 hours on yearly total hours worked per resident in the neonatal intensive care unit (NICU) and evaluates the association of resident duty hour reform, level of trainee, and the number of residents present at admission with mortality in the NICU. STUDY DESIGN:  This is a 6-year retrospective cohort study including all pediatric residents working in a Level 3 NICU ( N  = 185) and infants admitted to the NICU ( N  = 8,159)...
February 8, 2018: American Journal of Perinatology
Reinier G Hoff, Joost Frenkel, Saskia M Imhof, Olle Ten Cate
Postgraduate medical training in the Netherlands has become increasingly individualized. In this article, the authors describe current practices for three residency programs at the University Medical Center Utrecht: anesthesiology, pediatrics, and ophthalmology. These programs are diverse yet share characteristics allowing for individualized residency training. New residents enter each program throughout the year, avoiding a large simultaneous influx of inexperienced doctors. The usual duration of each is five years...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Riann Robbins, Sarah Sullivan, Brigitte Smith
BACKGROUND: The Accreditation Council for Graduate Medical Education mandates scheduled didactics for residency programs but allows flexibility in implementation. Work-hour restrictions, patient care duties, and operative schedules create barriers to attendance for surgical trainees. We explored vascular surgery trainees and faculty perceptions on trainees operative preparation and participation, and overall fund of knowledge after implementing an academic half day conference (AHD) schedule...
February 23, 2018: Surgery
Christopher A Adin, Callie A Fogle, Steven L Marks
To ensure patient safety and protect the well-being of interns and residents, the Accreditation Council for Graduate Medical Education (ACGME) issued guidelines in 2003 limiting the working hours of physician trainees. Although many supported the goals of the ACGME, institutions struggled to restructure their programs and hire staff required by this unfunded mandate. Numerous studies have analyzed the effects of duty hours restrictions on patient outcomes and physician training over the past 15 years. Most agree that duty hours restrictions improved well-being of house officers, but these improvements came at the expense of continuity, and patient hand-offs led to medical errors...
February 19, 2018: Veterinary Surgery: VS
Tony R Tarchichi, Jessica Garrison, Kwonho Jeong, Anthony Fabio
Background and objectives: Inpatient pediatric care is increasingly provided by pediatric hospitalists. This, in addition to changes in resident duty hour restrictions, has led to the creation of new models of care for inpatient pediatric patients. The objective of this study was to compare traditional outcome measures between a pediatric hospitalist-only service and a more traditional academic service in which care was provided by pediatric hospitalists, residents, and medical students...
December 2017: Pediatrics & Therapeutics: Current Research
Zi Zhang, Alan V Krauthamer, Andrew B Rosenkrantz
PURPOSE: In March 2017, the ACGME relaxed resident duty-hour restrictions to allow first-year residents to work 24-hour shifts, affecting the internship experience of incoming radiology residents. The aim of this study was to assess the media response to this duty-hour change, comparing news articles with favorable and unfavorable views. METHODS: Google News was used to identify 36 relevant unique news articles published over a 4-week period after the announcement...
December 28, 2017: Journal of the American College of Radiology: JACR
Vaughn A Starnes, Maura E Sullivan
Introduction Recent changes in surgical education have had an impact on our congenital training programmes. The mandate of the 8-hour workweek, a rapidly expanding knowledge base, and a host of other mandates has had an impact on the readiness of the fellows who are entering congenital programmes. To understand these issues completely, we interviewed the top congenital experts in the United States of America. The purpose of this paper is to share their insight and offer suggestions to address these challenges...
December 2017: Cardiology in the Young
Joey P Johnson, Kevin Savage, Joseph A Gil, Craig P Eberson, Mary K Mulcahey
BACKGROUND: In 2003 and again in 2011, the Accreditation Council for Graduate Medical Education (ACGME) mandated increasingly stringent resident duty hour restrictions. With less time required at the hospital, residents theoretically have more time for other academic activities, such as research. Our study seeks to examine whether the number of research publications by orthopaedic residents increased following implementation of the 2011 ACGME duty hour restrictions. DESIGN: Pubmed was queried using publicly available alumni lists from programs across the United States...
December 19, 2017: Journal of Surgical Education
Kareem R AbdelFattah, M Chance Spalding, David Leshikar, Aimee K Gardner
BACKGROUND: Current work hour restrictions and the expansion of requirements for surgery residents has led to decreased time on high-acuity rotations such as trauma and acute care surgery. In an effort to improve resident competency, we examined the efficacy of a new team-based trauma curriculum for postgraduate year 1 (PGY1) residents. METHODS: After completing required Advanced Trauma Life Support certification, PGY1s participated in a series of trauma simulations in 3-person teams from June to August...
December 8, 2017: Surgery
Kathryn R Wolf, Zachary A Taylor, Sarah B Placek, Michael W Tsai, Brenton R Franklin, E Matthew Ritter
PURPOSE: Operative experience is at the core of general surgery residency, and recently operative volume requirements for graduating residents were increased. The ACGME has outlined 4 areas of required resident participation and documentation in order for a surgical case to be logged: determination or confirmation of the diagnosis, provision of preoperative care, selection and accomplishment of the operative procedure, and direction of the postoperative care. The purpose of this study was to examine whether general surgery residents are currently meeting the required care participation documentation standard and to examine the effect of acute care vs...
November 2017: Journal of Surgical Education
Brandy Deffenbacher, Shannon Langner, Morteza Khodaee
BACKGROUND AND OBJECTIVES: A family medicine residency is a unique training environment where residents are exposed to care in multiple settings, across all ages. Procedures are an integral part of family medicine practice. Family medicine residency (FMR) programs are tasked with the job of teaching these skills at a level of intensity and frequency that allows a resident to achieve competency of such skills. In an environment that is limited by work hour restrictions, self-study teaching methods are one way to ensure all residents receive the fundamental knowledge of how to perform procedures...
November 2017: Family Medicine
Dennis J Butler, Joseph Brocato, Mark Yeazel
BACKGROUND AND OBJECTIVES: All family medicine programs are required to provide specialty-specific didactic conferences for residents. Since a baseline study of family medicine didactic formats was published in 2000, training requirements have changed, core content has evolved, and new teaching strategies have been recommended. The present study examines the characteristics of current family medicine didactics, compares current and past conference format data, and identifies factors affecting content selection...
November 2017: Family Medicine
Aneez Esmail, Maria Panagioti, Evangelos Kontopantelis
BACKGROUND: The UK is dependent on international doctors, with a greater proportion of non-UK qualified doctors working in its universal health care system than in any other European country, except Ireland and Norway. The terms of the UK exit from the European Union can reduce the ability of European Economic Area (EEA) qualified doctors to work in the UK, while new visa requirements will significantly restrict the influx of non-EEA doctors. We aimed to explore the implications of policy restrictions on immigration, by regionally and spatially describing the characteristics of general practitioners (GPs) by region of medical qualification and the characteristics of the populations they serve...
November 16, 2017: BMC Medicine
Pnina Weiss, Meir Kryger, Melissa Knauert
Many studies on resident physicians have demonstrated that extended work hours are associated with a negative impact on well-being, education, and patient care. However, the relationship between the work schedule and the degree of impairment remains unclear. In recent years, because of concerns for patient safety, national minimum standards for duty hours have been instituted (2003) and revised (2011). These changes were based on studies of the effects of sleep deprivation on human performance and specifically on the effect of extended shifts on resident performance...
December 2016: Sleep Health
Andrew Jordan Sun, Libo Wang, Minjoung Go, Zac Eggers, Raymond Deng, Paul Maggio, Lisa Shieh
BACKGROUND: Resident work hour restrictions have led to the creation of the 'night float' to care for the patients of multiple primary teams after hours. These residents are often inundated with acute issues in the numerous patients they cover and are less able to address non-urgent issues that arise at night. Further, non-urgent pages may contribute to physician alarm fatigue and negatively impact patient outcomes. OBJECTIVE: To delineate the burden of non-urgent paging at night and propose solutions...
October 21, 2017: BMJ Quality & Safety
Cara L Sedney, Eleni Spirou, Joseph L Voelker, Charles L Rosen
OBJECTIVE: Resident education in the United States and elsewhere has undergone significant changes in recent years owing to work hour restrictions, requiring didactics to fit within a limited schedule, while being increasingly effective at accomplishing educational goals. METHODS: A single small program experience in improving the didactic experience of residents is described. RESULTS: Focused mentorship, curricula for intangibles, asynchronous education, and independent curricula all are useful tools in resident education...
November 2017: World Neurosurgery
Alessandra Landmann, Heidi Mahnken, Mara B Antonoff, SuAnn White, Arpit Patel, Aaron M Scifres, Jason S Lees
OBJECTIVE: To qualify and characterize resident overnight activity. DESIGN: A prospective 3-phase study was conducted of surgical residents with attention to activities performed on the overnight rotation: needs assessment, direct observation of activities, and feedback. SETTING: This study was conducted at the University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. This is both a tertiary referral center and the only American College of Surgeons (ACS) verified level 1 trauma center in the state...
August 18, 2017: Journal of Surgical Education
Faris Shweikeh, Alexander C Schwed, Chiu-Hsieh Hsu, Valentine N Nfonsam
OBJECTIVE: To investigate the current rate of attrition in general surgery residency, assess the risk factors, and identify prevention strategies. DESIGN: A literature review of the PubMed and MEDLINE databases, from January 1, 1980 to February 1, 2016, for relevant articles. The calculated attrition rate and the statistically significant influencing factors were the main measures and outcomes. SELECTION: All English language articles that described attrition from a general surgery residency were included...
July 28, 2017: Journal of Surgical Education
Taryn S Taylor, Pim W Teunissen, Tim Dornan, Lorelei Lingard
PURPOSE: Although one proposed solution to the problem of fatigued medical trainees is the implementation of work hours regulations, concerns about the effectiveness of these regulations are growing. Canada remains one of the few Western jurisdictions without legislated regulation. Recent research suggests that fatigue is a complex social construct, rather than simply a lack of sleep; thus, the authors explored how regulations and fatigue are understood in countries with established work hours frameworks to better inform other jurisdictions looking to address trainee fatigue...
December 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Michelle M Shnayder, Joan E St Onge, Alberto J Caban-Martinez
OBJECTIVES: Napping has known benefits for fatigue mitigation and improved alertness. However the Accreditation Council for Graduate Medical Education (ACGME) New Common Program Requirements recently removed the 16 h work limit for PGY1 residents and removed any suggestions of napping. METHODS: We utilized a cross-sectional study design to administer a 44-item questionnaire in June 2016 to 858 residents and fellows at one large urban academic medical center. We assessed: 1) resident physician sentiment of work environment supportiveness for napping at work; and 2) agreement with 2011 ACGME guidelines on workweek hour limitations and strategic napping recommendations...
July 26, 2017: American Journal of Industrial Medicine
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