What to Expect in a Surgical Residency Program

Although the day-in-day-out grind of a surgical resident's life can vary depending on which specialty and which program you enter, there are some common features inherent in all surgical residents' daily schedules. One surgical resident at Baylor University Medical Center in Dallas, TX, reports that a typical three-day schedule looks like this:

A key element of a surgical resident's schedule is change. Every rotation brings different expectations and varying balances of consults, clinic, and operative time. Some programs use night float systems; others rely on 24-hour call without extended stretches of overnight shifts. 

As you evaluate programs and interview, ask specifically about call structure, scheduling expectations, and how residents feel about these arrangements. Whatever system a program uses, adaptability is essential. The ability to adjust to a new rotation's demands is one of the most valuable skills you can develop as a resident.

Work Hour Limitations

The ACGME adopted work hour protections in 2003 in response to concerns about resident fatigue and medical error. The current rules for all residency programs include:

• No more than 80 hours per week, averaged over four weeks (inclusive of in-house call and moonlighting)
• No more than 24 consecutive hours on duty (with additional transition time permitted for continuity of care and education)
• At least one day free from patient care and educational obligations per week, averaged over four weeks
• In-house call no more than once every three nights, averaged over four weeks