Fatigue, stress still prevalent among surgical interns a year after ACGME regulations

Even with new duty hour regulations that aim to curb fatigue, surgical interns are still struggling with burnout, stress and lack of sleep, researchers from the Mayo Clinic found in a study published in JAMA Surgery.

In 2011, the Accreditation Council for Graduate Medical Education (ACGME) limited medical interns to 16-hour shifts and increased supervision. Researchers studied the effects of that measure, surveying participants about well-being, education and burnout. Individual categories such as continuity with hospitalized patients and time spent in the operating room fared poorly, with more than half of participants believing both were decreased by implementation of the new hours, according to the study reseachers.

Eighty-two percent of participants--most male (68 percent) and under the age of 29 (69 percent)--reported a neutral or good quality of life, but symptoms of emotional exhaustion and depersonalization were reported more than once weekly by a quarter of participants. And 32 percent reported an unsatisfactory work-life balance.The strongest reactions were relatively scarce, however: Only 4 percent said they "regretted becoming a surgeon on a weekly basis," while 14 percent said they considered quitting on a weekly baisis. 

The authors of the study said it "raised important concerns over coordination of patient care and continuity with hospitalized patients" under the 2011-implemented regulations, with no significant quality-of-life increases since last measured in 2008.

FiercePracticeManagement spoke to wellness experts about the best ways to combat physician burnout. They agreed that physicians must be treated as a precious resource, given all the means they need to decrease their daily workload, take care of themselves and enroll in a wellness program if possible.

But when the ACGME came out with the 16-hour shift regulations in 2011, 78 percent surveyed in Mayo Clinic Proceedings believed the 16-hour shifts would endanger patient care, medical knowledge, interpersonal and communication skills and professionalism.

Meanwhile, a study published in the Archives of Surgery showed that sleep-deprived surgeons are a threat to patient safety. A surgical resident gets only 5.3 hours of sleep a day, the study showed, and that can lead to fatigue akin to being legally drunk, functioning at 70 percent mental effectiveness.

To learn more:
- read the study