The Present and Future Use of Physician Extenders in General Surgery Training Programs: One Response to the 80-Hour Work Week

re Canadian general surgery residents ready for the 80-hour work week? A nationwide survey

“…[9][10][11][12] To revamp residency programs and health care systems to comply with these restrictions, substantial resources have been invested, including implementation of the night float system and recruitment of additional nonphysician personnel to compensate for loss of resident hours. [13][14][15] Currently in Canada there are no national work-hour restrictions for residents in place; however, serious deliberations regarding work hours are progressing at the national and provincial levels within residency education committees and resident organizations. Critical analysis of patient outcomes, resident operative volume and impact on the health care system is warranted when structuring this protocol.…”

Cost Implications of ACGME’s 2011 Changes to Resident Duty Hours and the Training Environment

“…Next, we selected substitute providers. After 2003, programs shifted work among existing residents, hired midlevel providers (nurse practitioners and physician assistants), and gave attendings additional responsibilities; teaching hospitals hired more nurses 10,[17][18][19][20][21][22][23][24][25] . Few programs expanded, likely because the Balanced Budget Act caps Medicare-supported residency positions 26 .…”

Implementation of an “After Hours” Resident Educational Program in a General Surgery Residency: A Paradigm for Increasing Formal Didactic Training Outside of the Hospital Setting in the Era of the 80-Hour Workweek

“…This paradigm has driven novel ways of educating residents, including the use of new curriculum structure and incorporation of technology into the operative and didactic curriculum. 2,3,6,[9][10][11] At our institution, we conduct a "resident education retreat" in April of each year. During this time, residents meet as individual PGY classes to discuss their experience and identify any problem areas for improvement and potential change.…”