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Published 5 November 2009, doi:10.1136/bmj.b4260
Cite this as: BMJ 2009;339:b4260
Gretchen Purcell Jackson, assistant professor of surgery and biomedical informatics, John L Tarpley, professor of surgery and anaesthesiology
1 Vanderbilt Childrens Hospital, 220 Childrens Way, Nashville TN 37232, USA
gretchen.jackson@vanderbilt.edu
Restrictions on the working hours of doctors may be compromising surgical education and patient care. Gretchen Purcell Jackson and John Tarpley argue that greater flexibility is needed in applying regulations
| The first 150 words of the full text of this article appear below. |
The time required to train a competent surgeon is a hotly debated topic as working hours for medical trainees are increasingly restricted worldwide. Surgical disciplines are unique in that surgeons must not only acquire medical knowledge but also develop the manual dexterity and, sometimes, the strength and endurance to perform procedures. We examine the evidence from the United States on the effects of duty hour legislation on surgeons training.
Not all countries regulate working hours, but in those that do, the maximum hours per week for a doctor in training can range from as little as 37 hours in Denmark to 80 hours in the United States. The European Working Time Directive decreased the weekly hours for trainees to 48 in August 2009.1 In the United States, the Accreditation Council for Graduate Medical Education (ACGME) imposed a national limit of 80 hours weekly for all medical trainees in 2003. The
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