He points out that previously, before limits had been set, surgeons in residence often worked for 100 or more hours per week, which had numerous benefits. The sheer amount of experience a surgeon could expect to accrue over a five-year residency was far in excess of author Malcolm Gladwell's “10,000 hour rule,” which posits that 10,000 is the minimum number of hours required to gain working proficiency in any skilled endeavor.
Additionally, being able to stay on shift as long as was deemed necessary allowed surgical residents to provide continuous, knowledgeable care and support to their patients, whereas a resident forced to leave at an arbitrary time might be handing the care of patients off to others without giving them all the information they need to continue providing adequate care. He also notes that most experienced surgeons agree that during residency, a great learning opportunity may present itself at nearly any time. Working extremely long shifts allowed residents in previous years to increase the chances that they would be on hand for any such opportunity.
Dr. Stringel avoids the contentious question of whether or not the new work week limitations are having an adverse effect on new surgical residents, but he firmly maintains that such limitations have changed the face of the residency process. Therefore, to ensure continued effectiveness, surgeons must be open to changes in the way residencies are conducted.