Views of Surgery Program Directors on the Current ACGME and Proposed IOM Duty-Hour Standards

Purpose: The purpose of this study was to survey the experiences of surgery program directors with the current Accreditation Council for Graduate Medical Education (ACGME) duty-hour standards and views of the Institute of Medicine (IOM) proposed duty-hour recommendations. Methods: A total of 118 program directors (47.6% of all surgery programs in the US) responded to the survey. Results: Results showed that the current duty-hour standards have hindered clinical education opportunities by reducing or eliminating rotations on many services, didactic teaching conferences, and clinical bedside teaching opportunities. Additionally, patient safety has been compromised by frequent hand offs of care. Most IOM recommendations were perceived as extremely difficult or impossible to implement, with the exception of the moonlighting recommendation. The results indicated that adopting the IOM recommendations is not feasible given current workforce limitations, and most program directors supported maintaining the current duty-hour standards until such time as there is evidence-based outcomes research to direct change. Conclusions: The conclusion was that the current ACGME duty-hour standards have reduced teaching opportunities and narrowed the scope of training.