Duty-Hour Surveys Parse Perceptions of Interns, Program Directors

Eliminating two important limitations of this study might have put the interns more "in sync" with the program directors. First, large university programs constituted 10 of the 11 surveyed, and I suspect that those residents would be less concerned about duty-hour restrictions (because more of them subsequently choose fellowships and are less likely to go straight into general surgery practice) than would those from nonuniversity or community programs. Second, for 42.5% of the interns surveyed, there was no distinction made between those hoping to go into general surgery vs. those on track for surgical subspecialties, who are less likely to be concerned for the same reason of expecting additional training.

Even when we ignore the limitations of this study, I believe it shows that the "line in the sand" for the entire surgical community – residents and attendings – is no further resident duty-hour restrictions.

Mark L. Friedell, M.D., is from the department of surgery at the University of Missouri–Kansas City. His remarks are abstracted from an invited critique that accompanied the article (Arch. Surg. 2012;147:541). He reported having no disclosures.