Restricted Training Programs and Work Hours Result in Less Skilled Surgeons

A recent New York Times post reported that recent regulations restricting the number of hours medical residents can work in a hospital is turning out inexperienced doctors and surgeons who miss out on nearly a year’s worth of experience.

Over the past decade, the American Accreditation Council for Graduate Medical Education, the organization that approves medical and surgical training programs, has bowed to mounting pressure from politicians, unions, and sleep experts to restrict the time residents are permitted work.

The Times piece reported on a study conducted by the Annals of Surgery, the results of which were profound:

• Fewer than half of young surgeons could operate or make clinical decisions independently
• One-third were not capable of performing routine surgeries
• One-quarter could not recognize early signs of complications
• More than half of the doctors could not perform basic surgical maneuvers

In order to maintain accreditation, residency-training programs must abide by 22-pages of scheduling rules that address such things as the number of hours per week that can be worked in a hospital (no more than 80), the number of “free of duty” hours (eight hours off after 16-hour shifts and 14 hours off after 24-hour shifts), and “strategic napping” after 16 hours of continuous duty between the hours of 10 p.m. and 8 a.m.

Another study found that approximately 80% of young surgeons were choosing to extend their training by a year to improve their skills, and that failure rates on certifying oral exams at the end of residency have nearly doubled since the duty hour changes went into effect.

There is growing evidence that a surgeon’s operative skills and the number of surgeries performed directly correlates to patients’ outcomes.  Newer surgeons don’t receive the same training and experience that their predecessors did because of limits placed upon them.  For example, most residents in the past were able to participate in a surgery a day, while today’s new surgeons are lucky if they are able to participate in two or three operations a week.

Compounding the problem is the fact that surgical residents need additional skills consistent with advances in medicine and medical technology commonly used in operating rooms today. To make up for the lost time, many programs include on-line educational tools and simulated operating rooms, which Indiana University Medical School professor Dr. Samar G. Mattar, the lead author of the Annals of Surgery study, finds inadequate to “to compensate for real-world experiences.”

The attorneys at Sommers Schwartz are experienced in medical malpractice claims, including those that result from poor training and inexperience. If you or someone you know suffered as a result of surgeon’s error, call us today to discuss your case.