Resident University of Tennessee/Semmes-Murphey Clinic Memphis, Tennessee, United States
Disclosure(s):
William Mangham, MD: No financial relationships to disclose
Introduction: Since the introduction of duty hour restrictions by the ACGME in 2003, neurosurgery training programs have adjusted the on-call responsibilities of residents to maintain training standards while avoiding duty hour violations. Due to these changes many programs have transitioned to night-float systems, however, the frequency and extent of these changes has not been well studied in neurosurgery. The purpose of this web-survey based study was to investigate the organizational structure of on-call responsibilities for neurosurgery residents and assess how U.S. neurosurgery residency programs meet duty hour requirements while ensuring adequate training exposure.
Methods: After receiving IRB approval a survey link was emailed to program coordinators for each U.S. Neurological Surgery residency program using a web-based survey hosted on Google Forms. Follow up emails and phone calls were performed to increase participation. Statistical analysis was performed to evaluate all corresponding variables.
Results: A total of 73 programs responded to the survey (69.5% response rate). 30.1% of programs reported that they use primarily a night float system with integration of 24-hour weekend calls. Approximately half (50.7%) of programs reported having NP or PA support while on call. 90.4% reported coverage of a Level 1 trauma center on call. 57.5% of programs cover pediatric neurosurgery throughout residency. A majority of programs take “in-house” call (91.8%) during junior residency and "home call” during senior residency (94.5%).
Conclusion : We present the first nationwide survey of resident call responsibilities for U.S neurological surgery training programs. Almost one third of programs report using night float systems, and about half use NPs or PAs for additional support on call. Disparity exists regarding trauma and pediatric coverage. This study gives insight into current trends in neurosurgical residency training and could aid program directors and those involved in graduate medical education in understanding the role of on-call responsibilities in modern neurosurgery training.
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