J.Jpn. Surg. Soc.. 126(2): 131-137, 2025

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Feature topic

WORKSTYLE REFORM IN CARDIOVASCULAR SURGERY

The annual survey by the Japanese Board of Cardiovascular Surgery indicates that the mean weekly working hours for new applicants (i.e., residents) is 66.1 hours, while renewing applicants report an average of 59.2 hours. To remedy this situation, we have developed three strategies: 1) gradually advancing hospital centralization through an increase in the case number requirements for accredited training institutions and the reallocation of residents, ensuring both the quality of medical care and training efficiency alongside workstyle reforms; 2) institutionalizing task shifting as a requirement for certification; and 3) establishing an incentive system aimed at mitigating income loss due to reduced working hours through the establishment of a higher-level specialist certification program. The first initiative has been implemented since 2023, with a potential halving of core accredited facilities in the fields of adult cardiac surgery by 2028. The second initiative aims to require registered trained nurses to engage full-time in clinical ward duties and to ensure that treatment in semi-closed ICUs is conducted by either nurse practitioners or intensive care specialists. To realize the principles of workstyle reform, it is hoped that a robust medical care environment can be established without the necessity of legal restrictions on working hours.

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