title: Multidimensional effects of the 80-hour work week at the University of Michigan Medical School.
abstract: OBJECTIVE
  To examine the effects of the new resident work-hour restrictions on medical students, as measured by their perceptions of the quality of their experiences during the required clerkships.
  
  
  METHODS
  Evaluations of four clerkships were compared for two student cohorts at the University of Michigan Medical School. The first cohort, from the class of 2002-03, completed their clinical clerkships the year before the work-hour restrictions were implemented, and the second cohort, from the class of 2003-04, completed their clerkships the same year the restrictions were implemented.
  
  
  RESULTS
  There were significant and notable differences in the experiences of the two cohorts. Students' perceptions of the quality of their experiences in the surgery-oriented clerkships (obstetrics-gynecology and surgery) in particular were significantly lower (i.e., more negative) in the 2003-04 cohort than in the previous cohort for the same clerkships. The nonsurgery-oriented clerkships (internal medicine and pediatrics) hired hospitalists, who offset the residents' workload (internal medicine) and assumed teaching responsibilities (pediatrics). Between 2002-03 and 2003-04, students' perceptions of the quality of their experience in the internal medicine clerkship remained mostly stable, and increased in several areas for the students in the pediatrics clerkship.
  
  
  CONCLUSIONS
  Implementation of resident work-hour restrictions had significant effects on the education of the medical students studied. These effects need to be carefully analyzed and considered to ensure quality education for medical students. The findings also highlight that the nature of students' perceptions was related to preparations made (or not) by specific clerkships as restricted work-hour regulations were adopted.
authors.affiliation: Office of Medical Education, 3960 Taubman Medical Library, 1135 East Catherine Street, Box 0726, Ann Arbor, MI 48109, USA. bcwhite@umich.edu
authors.forename: Casey B
authors.initials: CB
authors.lastname: White
authors.forename: Hilary M
authors.initials: HM
authors.lastname: Haftel
authors.forename: Joel A
authors.initials: JA
authors.lastname: Purkiss
authors.forename: Amy S
authors.initials: AS
authors.lastname: Schigelone
authors.forename: Maya M
authors.initials: MM
authors.lastname: Hammoud
mesh_terms: D001290:Attitude; D002982:Clinical Clerkship / Q000458:organization & administration*; D015331:Cohort Studies; D006801:Humans; D008511:Medicine; D008824:Michigan; D009936:Organizational Innovation; D010561:Personnel Staffing and Scheduling; D015397:Program Evaluation; D013038:Specialization; D016526:Workload