THE PATH from medical school graduate to skilled, independent surgeon is long and rigorous. Those who travel it have much to learn along the way, not only about techniques to mend the ill and injured body, but also about the strength of human spirit, the dogged pursuit of elusive answers, and the bond formed when one life is entrusted to another. It is a challenge to balance these lessons with the need for sufficient rest.
The Massachusetts General Hospital surgical residency program has a proud tradition of training outstanding clinicians and leaders. Aspiring surgeons drawn to MGH represent an extraordinary group – gifted, highly motivated, ambitious, and committed to delivering the best care. They seek opportunities to immerse themselves in the many facets of the surgical journey, from the simplest stitch to the most complex resection, from spirited debates about tricky diagnoses to painful conversations with families. During their years of training, residents build a solid foundation of clinical wisdom and technical skills they will call upon for years to come.
Teaching hospitals are charged with shepherding this surgical metamorphosis during these crucial residency years. This remarkable process takes experience, practice, and perseverance – and precious time.
Since 2003, teaching hospitals have been required to limit work hours to 80 a week. The thinking behind this limit is logical. Too much work can mean a tired resident. Fatigue and lack of sleep can impair judgment, potentially leading to errors. Limiting work hours, therefore, could facilitate the rest needed for optimal performance and foster the balance between professional and personal life, easing the once-grueling residency schedules of the past.
Limiting work hours, however, also comes with significant drawbacks. Mandated limits lead to more handoffs between caregivers, increasing opportunities for miscommunication and creating a new set of errors that may offset any safety gained from well-rested residents. Shorter shifts also mean reduced time observing, practicing, and learning in the operating room, and less time with patients and families.
