Medical Residents Divided on Work-Hour Changes

A recent survey of medical residents, published in the New England Journal of Medicine, finds that newly minted doctors are divided on new work-hour rules—and many tend to view them negatively. At least one advocate of the reforms, however,  questions how well residents understand the changes—or the rationale behind them.

In September, Accreditation Council for Graduate Medical Education (ACGME) approved a set of requirements that, among other provisions, preserves the 80-hour limit on the resident workweek and requires that first-year residents work no more than 16 hours continuously.

The authors surveyed residents nationwide about the likely effects of the revised standards. Twenty-three institutions in 15 states agreed to participate in the 20-question survey, the investigators report; 11,617 residents received the survey. The response rate was 22 percent.

Opinions varied, but most respondents (51 percent) indicated the changes would have a positive effect on residents' quality of life and well-being; 28 percent said it would have a negative one.

Respondents were somewhat negative on patient safety. Thirty-four percent indicated the changes would positively affect patient safety; 39 percent said patient safety would be negatively affected.

They had more negative views, however, about the impact on the quality of care delivered to patients (41 percent negative, 33 percent positive). Moreover, in their written responses, many "expressed concern about diminishing patient safety and the quality of care by increasing the number of patient handoffs and reducing the continuity of care, which the changes will necessitate in most programs," the authors wrote.