Work hour regulations: do we need further changes now? A survey of internal medicine faculty and residents

In 2003, the Accreditation Council for Graduate Medical Education standardized and regulated work hours for physicians in training in the United States. In December 2008, the Institute of Medicine (IOM) recommended further reductions in duty hours to ensure safer conditions for patients and residents and fellows. Significantly, the IOM committee acknowledged that there are barriers to implementing its recommendations.

IN THE WAKE OF THE IOM PROPOSALS, WE CHOSE TO SURVEY A REFERENCE CLOSER TO HOME: residency program directors, faculty, and residents. Our survey allowed them the opportunity to express their opinions regarding the IOM proposals.

The majority of the faculty oppose the proposed IOM changes, arguing that there is no definite evidence to support the hypothesis that fewer work hours mean better outcomes in patient safety and education. First-year residents and residents who moonlight were more likely to experience stress and to support decreased work hours.

The thoughts and opinions of faculty and residents collected through this survey, in combination with evidence-based studies from trial implementation of these standards, will contribute real answers to the challenging questions on resident work hours.