Multi-Institutional Survey Suggests Duty Hour Violations and UnderReporting by Surgical Interns

Background: Surgical residents may be perceived as silent violators of duty hours as they try to balance patient care and regulatory compliance. Methods: In order to examine the perspective of general surgery interns on their reporting of work hours, a survey questionnaire was distributed between May 6 and June 3, 2019 to first year surgical trainees at four major academic institutions near the end of their internship year. Results: A total of 25 of 59 interns participated in our survey (42.4% response rate). Work-life balance was consistently rated as the most significant challenge facing surgical interns. All (100%) interns had at one time under-reported work hours, while 28% did so “often”, and 32% “occasionally”. Interestingly, one in five surgical interns reported receiving external pressure from their residency program to under-report working hours. Conclusion: Surgical interns have difficulties adequately balancing their life with the rigorous work of a surgical resident, and that nearly all surgical interns both violate and under-report their work hours. Understanding the reasons why surgical trainees decide to under-report duty hours would help surgical educators develop innovative, non-punitive methods to improve work hour compliance.