Residency Program Directors' Perspectives on Overtime Duty Hours and Professional Development Time in Japan

This study aimed to explore the perspectives of residency program directors in Japan regarding overtime duty hours and the balance between clinical training and self-improvement activities. This study explores the impact of work-hour regulations on resident well-being and training quality, contributing to global discourse on medical education reform.

A cross-sectional survey was distributed to 701 residency training hospitals across Japan to investigate their readiness for new duty-hour limits under the Medical Care Act, which categorizes working hours into Level A (960 hours/year), Level B (1440 hours/year), and Level C-1 (1920 hours/year). The survey, conducted from October 18 to December 15, 2023, achieved a 36.2% response rate (n=254). Key questions included: "Considering the balance between clinical skills development and mental well-being, what do you think is the optimal number of overtime duty hours per month for resident physicians?" Statistical analysis included descriptive statistics and Chi-square tests to compare responses across hospital types.

Most directors favored a conservative overtime limit of 40 hours per month (mean ± standard deviation: 40 ± 21 h), with 24.0% expressing this preference. These findings reveal a significant evidence-practice gap, suggesting that current practices often exceed recommended limits, highlighting a need for alignment between policy and implementation.

This study provides insights into the complex interplay between resident training demands and well-being under Japan's new duty-hour reforms. It offers valuable insights for policymakers and educators aiming to optimize training environments and enhance resident well-being globally.