There are more than 6,000 U.S. hospitals, with approximately 3,500 actively practicing board-certified neurosurgeons serving a population of over 303 million people. About 150 neurosurgery residents graduate every year from the 99 accredited U.S. neurosurgery training programs. Since July 2003, residents in most programs have been limited to an 80-hour work week, although in some programs they are allowed to work up to 88 hours. This change was implemented by the Accreditation Council on Graduate Medical Education (ACGME).
The six- or seven-year neurosurgical training program begins with one year of internship and generally ends with one year of chief residency. Neurosurgical residents must acquire extensive knowledge and experience in treating patients with a wide variety of neurological disorders. It is essential that they develop the judgment and ability to assimilate significant and varying technical skills, in order to perform demanding operative procedures, many of which are done on an emergency basis, and can take as long as 16 hours to perform.
Researchers at Feinberg School of Medicine, Northwestern University, University of Arizona College of Medicine, and Arizona State University investigated the effect of fatigue on neurosurgery resident performance. The results of this study, The Effect of Call on Neurosurgery Residents' Skills: Implications for Policy Regarding Resident Call Periods, will be presented by Aruna Ganju, MD, FACS, 5:16 to 5:23 pm, Tuesday, May 4, 2010, during the 78th Annual Meeting of the American Association of Neurological Surgeons in Philadelphia. Co-authors are Kanav Kahol, PhD, Peter Lee, MD, Narina Simonian, BS, Steven J. Quinn, BA, John J. Ferrara, MD, and H. Hunt Batjer, MD, FACS.
In December 2008, the Institute of Medicine recommended that further work hour restrictions be imposed upon resident physicians. In response, the ACGME critically reviewed the benefits of the 80-hour work week restrictions during the first five years of implementation. It was revealed that little data exists regarding the effect of work hour restrictions upon patient safety or resident education. A one-size-fits-all approach to resident duty hours − which assume that all areas of medicine have similar demands and that all resident physicians have a similar set of interests, skills, and endurance − does not account for the unique characteristics required for success in specific areas of medicine.
"While fatigue and its effects on surgical proficiency have been an actively researched area for the last 10 years, past studies have not examined the effect of fatigue on neurosurgery residents specifically. This study aims to quantify the effect of fatigue on the psychomotor and cognitive skills of neurosurgery residents," remarked Dr. Ganju.