Over the last ten years, educators have vigorously debated the rules and regulations governing residency training program work schedules. Some educators believe that resident work hours must be strictly limited. Two arguments are made for this view. 

One focuses on the effect of long hours on the residents themselves, and argues that traditional schedules involving long shifts without sleep are simply brutal and dehumanizing. The other argument focuses on the effect of long hours and resident fatigue on patients and argues that tired residents make more mistakes and harm patients.

Educators who oppose limits on work hours also make two arguments. First, many believe that limits on resident work hours make it impossible to adequately train residents. This, they argue, will also harm patients by exposing them to doctors who are inadequately prepared. Second, they argue that shorter work hours disrupt continuity of care and lead to more mistakes as a result of miscommunication among residents as they sign out to one another. In 2003, resident work hours have been officially limited by the committees that accredit residency programs. Further mandated reductions are to kick in on July 1, 2011.

We present, here, some data on the effects of these changes. So far, it seems, the reduction in work hours has not led to measurable decrements or measurable improvements in the quality of care. It has, however, led to residents who are somewhat better rested. We will have to wait and see whether further reductions lead to more dramatic changes, or whether work hours are not as tightly correlated with patient outcomes as suggested by educators on either side of the divide.

- last updated 05/03/11

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REFERENCES - last updated 06/01/11