The surgical residency and Accreditation Council for Graduate Medical Education reform: steep learning or sleep learning?

• Published in: The American journal of surgery 2011-06, Vol.201 (6), p.715-718
• Main Author: Nauta, Russell J., M.D., F.A.C.S
• Format: Article
• Language: English
• Subjects: Accreditation - methods; Arches; Athletes; Conditioning; Discipline; Education; Education reform; Education, Medical, Graduate; General Surgery - education; Guidelines; Health education; Hospitals; Humans; Initiatives; Internship and Residency - methods; Learning; Medical personnel; Medical residencies; Norms; Physicians; Professionals; Professions; Program Evaluation; Revisions; Sleep; Supervision; Surgeons; Surgery; Training; Trends; United States; Working hours
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2010.11.013

[...]we would be surprised to find Julliard chasing people from the piano after a specified number of hours, or a point guard contending that his jump shot became better while he dreamed about it during a nap. No matter how high the expectations of their mentors might be, professionals in training often exceed them, have accepted their role as conditioned athletes, and expect to be judged not by average external standards or those of other professions, but by the more demanding norms established and upgraded by pushing the limits of physical and intellectual activity. future and wondering whether the ACGME rules, even as modified, will produce a professional capable, inclined, and experientially trained to delivering the required care. Current ACGME guidelines, derived from conclusions drawn from anecdotal reports of unsupervised nonsurgical residents, are inapposite to graduate training programs in surgery. [...]surgical RRCs and the ABS who embraced the 2003 reforms in good faith should withhold endorsement of more regressive ACGME modifications, if only because the previous guidelines have demonstrably failed to produce improvement in any measurable educational parameter. Tying federal funding for surgical residency to oversight and approval of surgical residencies by a discipline-specific educational body such as the American College of Surgeons is a feasible alternative that would reliably and specifically address the needs of surgical training. The ACGME revisions have gone too far. 1 K.I. Bland, G. Isaacs, Contemporary trends in student selection of medical specialties: the potential impact on general surgery, Arch Surg, Vol. 137, 2002, 259-267...