Canadian Plastic Surgery Resident Work Hour Restrictions: Current Practices and Perceptions of Residents and Program Directors

Purpose: To examine the current practices and perceptions of Canadian plastic surgery residents and program directors regarding work hour restrictions.

Methods: An anonymous online survey developed by the authors was sent to all Canadian plastic surgery residents and program directors. Basic summary statistics were analyzed.

Results: Responses from 80 residents (53%) and 10 program directors (77%) were received. Residents reported working an average of 73 hours in hospital per week with 8 call shifts per month. During call shifts, they reported an average of 5 hours of sleep. Most residents (88%) reported taking an average of 0 post-call days off per month and 61% always work post-call regardless of how much sleep they’ve had. Most respondents (63%) reported wanting the option of working post-call and 77% do not want their work week restricted to 80 hours.

Resident surgical and medical errors attributed to post-call fatigue were perceived by 26% and 49% of residents, and similarly, 30% and 40% of program directors, respectively. The majority of respondents believe (percentage of residents and program directors in agreement, respectively) the surgical (77%, 90%) and medical (74%, 60%) abilities of residents, and their ability to learn (82%, 70%), suffer if they’ve been up most of the night. It was also felt that residents won’t have enough time to master their surgical skills if they don’t work post-call (53%, 80%). Residents perceived pressure from attending surgeons (56%) and other residents (53%) to work post-call. No program directors (0%) reported expecting their residents to work post-call on very little sleep.

Conclusions: The majority of Canadian plastic surgery residents responding to this survey do not take, nor want, post-call days off. Residents and program directors agree that surgical and medical abilities were perceived to decrease with little sleep, however the desire of residents to master surgical skills and meet perceived expectations appears to encourage them to work post-call.