Journal of surgical education
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Comparative Study
General surgery residents' views on work hours regulations.
Since 2003, compliance with Accreditation Council on Graduate Medical Education (ACGME) work hours regulations has been required for United States residency training programs. Further work hours restrictions have been proposed by the Institute of Medicine (IOM). This study examines General Surgery residents' views of current work hours restrictions and proposed changes by the IOM. ⋯ General surgery resident physicians in the US do not always record their work hours accurately and many have concerns about further work hour restrictions. The majority admitted underreporting work hours to care for a sick patient. Most US surgical residents feel further work hour restrictions would be detrimental to their training. Current work hours restrictions force surgery residents to underreport their work hours to perform the activities that they feel are necessary for their surgical training.
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To examine the relationship between and predictive nature of United States Medical Licensing Examination(®) (USMLE) Step 1, Step 2, and American Board of Surgery In-Training Examination (ABSITE) postgraduate year (PGY) 1-5 scores from 2 general surgery programs from 1999-2009, with a goal of discerning how Step 1 and Step 2 scores should be used in resident selection and screening. ⋯ USMLE Step 1 scores showed limited utility in predicting later ABSITE scores whereas Step 2 scores were more predictive of all years of ABSITE scores. These findings should prompt additional research into the relationship between examination performances at different points along the general surgery education continuum. In the mean time, general surgery program directors and faculty might do well to examine the relationships between Step 1 and Step 2 scores and ABSITE scores in their own programs to evaluate the usefulness of considering either score when ranking potential residents for selection into a program.
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The Accreditation Council for Graduate Medical Education (ACGME) uses the resident/fellow survey to assess residency programs compliance with ACGME work hours regulations. Survey results can have significant consequences for residency programs including ACGME letters of warning, shortened program accreditation cycle, immediate full program and institutional site visits, or administrative withdrawal of a program's accreditation. Survey validity was assessed by direct query of general surgery residents who answer the survey each year. ⋯ One hundred thirty-three residents (14%) admitted to not answering the questions truthfully while 352 (37%) of residents felt that the survey did not provide an accurate evaluation of their work hours in residency training. An evaluation tool in which 1 in 7 residents admit to answering the questions falsely and 1 in 5 residents had difficulty interpreting the questions may not be a valid method to evaluate compliance with work hours regulations. Evaluation of work hours regulations compliance should be based on actual work hours data rather than an anonymous survey.
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In recent years, a significant decline in the number of medical school graduates who choose general surgery as a career has been noted in Israel. The aim of this study is to characterize the factors that deter Israeli medical students from choosing general surgery. Previous studies in the United States identified lifestyle and financial issues as the most important factors. ⋯ More medical graduates would consider general surgery as a career option if the lifestyle and inter-relationships were perceived as better. An increase in monetary reward did not seem to have a paramount impact among Israeli medical graduates. The surgical clerkship is an important turning point in the students' attitude toward surgery as a career and efforts must be made to improve students' experience significantly during this clerkship.