Is physician competence affected by duty hour regulations?

In an effort to improve patient safety and physician wellness, the ACGME implemented duty hour reforms at accredited teaching hospitals to restrict resident duty hours in recent years. In 2003, resident work hours were capped at 80 hours per week averaged over a four-week period, and shift lengths were restricted to be no longer than 30 hours. In 2011, duty hours were restricted further. The new standards required that shift lengths be kept to a maximum of 16 hours for first-year residents. Upper-level residents could be scheduled for shifts no longer than 24 hours with the option to stay on for an additional four hours to address transition care or attend educational conferences.

Generally, those in GME in favor of the reforms reasoned that by reducing duty hours, residents would be less fatigued, which would result in improved patient care. Those who argued against the reforms voiced concerns that increased patient handoffs and less clinical experience for physicians in training could lead to worse patient outcomes. In an attempt to determine what effect duty hour reforms actually had, several researchers have produced studies examining patient outcomes.

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