Comments of the
Society of Neurological Surgeons
American Board of Neurological Surgery
American Association of Neurological Surgeons
Congress of Neurological Surgeons
to the
Accreditation Council for Graduate Medical Education
on the subject of
ACGME Review of Resident Duty
Hours Policy
Executive Summary
1) Your organization’s formal position on the current ACGME resident duty hour requirements,
including impact analysis, from your organization’s perspective, on costs and impact of
implementation.
Summary Statement:
Mastery of the knowledge and skills required to manage expertly the extensive and wide-ranging
list of neurosurgical disorders requires many years of commitment and intensive experience.
Neurosurgical practice is unlike many other medical specialties. Neurosurgical procedures are
long — lasting an average of four hours, but often more than eight to ten hours — and the learning
episodes — from presentation, through evaluation, surgical treatment, and immediate
postoperative care — can be very long. To obtain the most educational value from these learning
episodes, and to best serve their patients, residents must be able to participate in each phase of
the learning episode. These learning episodes frequently cross the “shift” boundaries set up by
work hour restrictions.
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