Special features topic: the effects of limited work hours on surgical training in otolaryngology-head and neck surgery.
OBJECTIVE
This paper reviews the historic events that culminated in the development of duty hour regulations, and then discusses many of the problems being encountered as the regulations are implemented.


RESULTS
On July 3, 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted duty hour requirements for residency training programs in the United States. Although these regulations should have come as no surprise to graduate medical education programs, many were nevertheless unprepared for their implementation. In comparison to duty hour restrictions currently in place in European countries, those being implemented in this country are much more lenient. Both the fiscal and the educational impact of these requirements on graduate medical education are substantial. Recent accreditation actions taken against a training program at Johns Hopkins University clearly demonstrates that the ACGME is prepared to strictly enforce these standards.


CONCLUSIONS
The impact of the new duty-hour requirements on residency training and education will be a matter of great interest as they are implemented throughout the graduate education system in the United States.
Tami
Thomas A
TA
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0528, USA. Thomas.Tami@uc.edu
D000068:Accreditation / Q000331:legislation & jurisprudence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000331:legislation & jurisprudence*; D006785:Hospitals, University / Q000331:legislation & jurisprudence; D006801:Humans; D007396:Internship and Residency / Q000331:legislation & jurisprudence*; D013517:Otorhinolaryngologic Surgical Procedures / Q000193:education*; D010561:Personnel Staffing and Scheduling / Q000331:legislation & jurisprudence*; D014481:United States; D014940:Work Schedule Tolerance