[Working hours of gynecology-obstetrics residents: Balancing training and regulations]

Exceeding the legal working hours of residents, particularly in on-call specialties such as obstetrics and gynecology, raises significant issues regarding patient safety, work-life balance, and training. Despite European regulations limiting weekly working hours to 48, available data indicate a systematic overrun, particularly on weekends, without adequate compensatory time off. This study aimed to compare the weekly working hours of residents between a period before the implementation of compensatory days off and a subsequent period. Secondary objectives included assessing the feasibility, impact on annual leave, theoretical training days, and clinical activity related to the compensatory rest.

A retrospective observational before-and-after study was conducted at a French university center over two one-year periods (November 2022 to October 2024). A regulatory measure was established starting in November 2023, involving the allocation of compensatory days off after weekend on-call shifts (1 day for Friday and Sunday, 2 days for Saturday). The theoretical weekly working hours were calculated according to a standardized formula that incorporated on-call duties and compensatory rest. Data on the number of on-call responsibilities, internship posts, leaves, and training were collected for each intern from weekly schedules.

The study included 46 residents over two years (20 in the pre-implementation period, 26 in the post-implementation period). The weekly working hours significantly decreased after the introduction of compensatory days off (52.1h vs. 47.7h, p<0.001). The number of individual training days decreased during the post-implementation period, but there was no significant impact on the number of clinical internship days in key sectors.

The implementation of compensatory days off after weekend on-call duties is a feasible and effective measure to reduce the weekly working hours of residents. It allows for compliance with regulatory requirements while maintaining clinical activity or continuity of care.