C2A - 10: MILLENNIAL MEDICAL STUDENTS EXPECT SURGICAL AND MEDICAL RESIDENTS TO VIOLATE WORK HOUR RESTRICTIONS
Natalie A O'Neill, MD, Rami S Kantar, MD, Stephen M Kavic, MD, Eric D Strauch, MD; University of Maryland School of Medicine

Introduction: Medical student perceptions of work hours in the post- work hour restriction era remain largely unknown. We hypothesized that medical students’ classical residency stereotypes will influence students to expect to work more hours during their third year surgical clerkship rotations.

Methods: Third year medical students (academic year 2016 – 2017) completed surveys on the first and last day of their surgical clerkship. Fisher’s exact test was used to calculate p-values for categorical variables, where p<0.05 was significant.

Results: Survey response rate was 94% (135/143 students). Estimated work hours by students were similar before and after their surgical clerkship (Figure 1). More students anticipated (16%) and reported (18%) working >80 hr/week on their surgical clerkship compared to their medicine clerkship (5%, p=0.003; 4%, p=0.0003, respectively). Similarly, students expected (90% pre-survey) and estimated (90% post-survey) surgical residents to violate work hour restrictions more than medicine residents (52%, p<0.001; 47%, p<0.001, respectively). Notably, one in 5 students felt “commute to work” and “studying for exam” should be included in resident work hours.

After the surgical clerkship, significantly fewer students considered “value in staying late for educational opportunity” as a reason for work hour violation (48%) compared to before the clerkship (60%, p=0.05), and there was a trend toward an increase in “lack of belief of work hour restriction” (pre-survey 35% vs. 45% post-survey, p=0.08).

Conclusion: Medical students anticipate that both medical and surgical residents work extended hours, though surgeons more frequently. This may be creating a confirmation bias as students estimate both their own and others’ work hours. More than a decade since the implementation of work hour restrictions, the folklore of the ever-working surgeon persists.