Sleepy surgical students do make more mistakes. That’s the headline of another article in the Globe and Mail. It’s a short article and it basically regurgitates a new study published in the Archives of Surgery. The study looked at the results from routine surgery and concluded that reducing on-call hours for surgical students to 80 hours per week (down from as much as 120 hours per week in some cases) improved patient outcomes. I don’t have access to the study but the results quoted in the paper are hardly earth shattering.

“Before the work restrictions took effect, about 1 per cent of patients experienced a bile duct injury…”

“After the new hours were imposed, the injury rate dropped to 0.4 per cent. What’s more, other surgical complications dipped to 2 per cent from 5 per cent.”

Certainly any improvement in patient outcomes is desired but I wonder if any other factors, beyond on the on-call hours, influenced the outcome. After all, this is one study of one surgical procedure at one teaching hospital.

The article also mentions that some medical professionals argue that less on-call hours prevents surgical students from getting enough on-the-job training.

Those of you who have read some of my previous blog posts might believe that I am in favour of reduced on-call hours for surgical students but the truth is that I am not convinced.

Surgery is one of those careers where the proper training can mean the difference between life and death. While the benefit of more sleep is unquestionable, I have to weigh it against the benefit of more experience. One reason for working surgical students so hard is that surgery is a demanding career, with surgeries that can last for hours. Being able to perform complex surgery regardless of one’s mental or physical fatigue is a requirement for a good surgeon.

So while this study shows how reduced on-call hours result in a minor reduction in surgical complications for a routine surgery, I can’t help but wonder how this will impact those surgeons in the future. Will future generations pay the price by having less experienced and less capable surgeons? I doubt we’ll ever know the answer but I think it is a question that should be asked.