Original ReportsPerceived Effects of the 16-Hour Workday Restriction on Surgical Specialties: Quebec’s Experience
Section snippets
Methods
This survey-based study was approved by our institution’s ethic committee. We constructed an online survey consisting of 19 multiple-choice questions, of which 10 were based on a Likert-type scale. The questionnaire was designed to assess the perception of the effects of the new duty-hour restrictions on the educational environment, quality of care, and quality of life. For the first item, the Surgical Theater Educational Environment Measure20 and the Postgraduate Hospital Educational
Analysis
Only surveys that were 100% completed were analyzed. As a mention, McGill University sent our survey to both surgical and nonsurgical programs. Nonsurgical respondents were identified through those who had stated their specialty as other, a category for which specifying the exact field of practice was mandatory. Questionnaires from nonsurgical specialties were excluded and deleted from this study. All data collection and statistical analyses were performed using R Core Team 2012 (R: A language
Study Demographics
A total of 153 residents and 127 professors completed the survey. Demographics of survey respondents including sex, residency level, years of teaching, surgical specialty, university, on-call system worked in, and knowledge of the new regulations are shown in Table 2.
Most residents who responded were male and junior residents (postgraduate years 1-2). Most were related to general surgery (46%) and orthopedics (20%). Overall, 24.8% of the residents were from McGill University, 18% were from
Discussion
This survey demonstrates concern among surgical residents and professors that the quality of education might be compromised by the new duty-hour regulations. All areas pertaining to the educational environment were felt to be negatively affected by the restrictions. This finding is even more pronounced among professors, which is important with regard to their knowledge on the educational experience that residents need for a comprehensive training. Conversely, residents base their perception on
Conclusion
This survey-based study indicates that residents and professors perceive a mild negative effect on the educational environment and quality of care 6 months following the implementation of new restrictions. However, overall, the effect on quality of life is perceived as negative with the new restrictions. Professors seem concerned about adequate training to the point of considering increasing training length. Further evaluation is needed to compare on a longitudinal basis these perceptions. In
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2020, Canadian Journal of SurgeryAttitudes and factors contributing to attrition in Canadian surgical specialty residency programs
2017, Canadian Journal of SurgeryCitation Excerpt :Alleviating lifestyle issues cannot be as simple as merely reducing working hours, as the introduction of the 80-hour working week was met with a paradoxical increase in resident attrition from general surgical programs in the United States.6 Similarly the introduction of a 16-hour maximum workday restriction in Quebec was met with a perceived reduction in quality of life by the affected residents and perceived deteriorations in the quality of care for patients and quality of training for residents by the professors involved.16 All surgical specialties require a certain amount of hard work, and the nature of the job often involves working antisocial hours, so perhaps it is not unreasonable to shift the focus of attention onto the first question: how can programs select medical students who are committed enough to their specialty to see residency through to completion?
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