title: The perceived impact of duty hour restrictions on the residency environment: a survey of residency program directors.
abstract: OBJECTIVE
  The purpose of this study was to characterize residency program director baseline perceptions regarding the effect of resident duty hour limitations on key components of the graduate medical education environment.
  
  
  METHODS
  This was a survey of directors of accredited obstetrics and gynecology residency programs in the United States (excluding New York State) between June 21st and July 16th, 2004. Participants were queried on views regarding the need for duty hour limitations, and the perceived effect of these changes on various issues related to the residency environment.
  
  
  RESULTS
  Fifty-eight percent (123/211) of the study population completed the questionnaire. Seventy-one percent of respondents supported duty hour restrictions, 19% opposed restrictions, and 10% were undecided. Forty-one percent of respondents preferred a maximum duty hour limitation of 80 hrs/wk or less, 55% preferred one at least 90 hrs/wk, and 4% preferred no upper limit. A significantly greater proportion of female program directors supported limits > 80 hrs/wk than males (73% vs 53%, P = .04). A majority of participants believed resident education, surgical skills, and work ethic have been negatively impacted by the limitations, while patient safety and the overall quality of patient care have remained unchanged or declined, and resident well-being has improved. Opposition to duty hour regulations and a preference for higher limits was associated with a higher prevalence of negative impressions regarding the impact of duty hour regulations on the residency environment.
  
  
  CONCLUSIONS
  Variations in current opinions regarding the impact of residency duty hour restrictions reflect ongoing bias in those most influential to resident education.
authors.affiliation: Department of Obstetrics and Gynecology, Center for Research in Women's Health, University of Alabama, Birmingham, USA. francis@nuthalapaty.net
authors.forename: Francis S
authors.initials: FS
authors.lastname: Nuthalapaty
authors.forename: Alissa R
authors.initials: AR
authors.lastname: Carver
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Nuthalapaty
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Ramsey
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010561:Personnel Staffing and Scheduling; D008486:Physician Executives / Q000523:psychology*; D011795:Surveys and Questionnaires; D016526:Workload