The procedures and policies in place to train orthopedic surgeons need serious changes to meet growing demand and patient care, this according to an article in the January issue of The Journal of Bone and Joint Surgery. The article was written by researchers at the Hospital of Special Surgery (HSS).  January issue of The Journal of Bone and Joint Surgery published a study by researchers at Hospital of Special Surgery (HSS).

Dr. Laura Robbins, the HSS vice president of education and academic affairs, said this about the report: “Before this study, we at Special Surgery thought that we were the only hospital dealing with these complicated challenges. As a result of this study, we have come to realize that as a nation, the prominent training programs around the country are grappling with these same issues.”

One of the chief concerns, according to the report, is the work-hour restrictions set in place by the Institute of Medicine. The rules strictly prohibit resident trainees to work more than 24 hours, have shift breaks, and one day off every seven. While over-working resident trainees is a valid concern, strict rules like these prevent the resident from treating the patient from pre-surgery to post-surgery. This creates discontinuous care, which not only could jeopardize patient care, but also the effectiveness of training.

Additionally, the report points out that gender and generational changes among orthopedic surgeons have created new challenges. Many programs do not provide up-to-date training techniques, such as electronic technology, to help better provide the trainees with the flexibility and effectiveness they desire. In short, orthopedic programs are unable to keep up with the evolving needs of trainees.

Finally, another major concern in the report is antiquated restrictions look to jeopardize patient care and further burden current resident surgeons. The number of trainees that programs can accept has been capped for at the same level for 20 years, even while demand has increased significantly. Dr. Robbins commented on the finding, saying “we know from projections in studies that there won't be enough orthopedic surgeons in the future for the baby boomers who will need joint replacements.”

These are all very valid concerns, and really demonstrate the balancing act caregivers and policymakers must strike in order to ensure patient care. Later this year, when the researchers reconvene to make substantive recommendations, it will likely be a much-needed step forward in the orthopedic surgery field. Until then, the risk of under-trained and overworked orthopedic surgeons is simply too great.