© Springer International Publishing AG 2018 163
T.S. Köhler, B. Schwartz (eds.), Surgeons as Educators,
https://doi.org/10.1007/978-3-319-64728-9_9
Resident Duty Hours in Surgical
Education
David J. Rea and Matthew Smith
The topic of duty hours in surgical education is one that stirs a great deal of emotion
in all surgeons. As surgeons, we are products of our own training environments and
inherently biased about how the time spent in patient care and educational endeav-
ors has shaped our current abilities and surgical careers. It is not uncommon for a
group of surgeons to wax poetic about our training programs, the “surgical giants”
who influenced us in both a positive and negative manner, and the tragicomic events
that have taught us important lessons about patients and surgical disease that we find
fundamental to our personal approach to surgical problems. The rigors of the surgi-
cal education process have made an indelible imprint on our lives as “physicians
who operate.”
The heart of the many debates of the role of duty hours in surgical education has
been the question of how much “time” is needed to educate a knowledgeable and
technically competent surgeon who can independently take care of surgical patients.
The research of psychologist K. Anders Ericsson has extensively evaluated high
performing individuals, and his findings have suggested that it takes about
10,000 hours of deliberate practice to attain expert performance [ 1 ]. This
10,000 hours has been studied across varied disciplines including music, sports, and
medicine [ 2 ]. A similar thesis has been argued by Colvin in his book Talent is
Overrated [ 3 ]. Whatever natural aptitude we have can be supplanted by deliberate
practice with highly skilled coaching to guide our activities. How does this apply to
what surgeons do? Is it valid to compare practicing a musical instrument or a golf
swing to the breadth of knowledge that surgical residents must master to adequately
D.J. Rea, MD, FACS (*) • M. Smith, DO
Division of General Surgery, Department of Surgery, Southern Illinois
University School of Medicine, 701 N First Street, PO Box 19638,
Springfield, IL 62794-9638, USA
e-mail: [email protected]