Myths and realities of the 80-hour work week.
BACKGROUND
Myths are so ingrained into cultural traditions that emotion frequently overshadows a rational evaluation of the facts. The reduction in resident work hours has resulted in the formation of several myths. The purpose of this review is to examine the published data on resident work hours to separate out myth from reality.


METHODS
An electronic database was searched for publications related to resident training, work-hours, continuity of care, sleep deprivation, quality of life, patient safety, clinical/operative experience, faculty work hours, and surgical education.


RESULTS
Sleep deprivation has been shown to be harmful, and residents played a role in advocating for work-hour limits. Surgical residents have seen a less dramatic improvement in quality of life compared with other disciplines. Work-hour reductions have decreased participation in clinic but have not resulted in a significant decline in clinical or operative exposure. Limiting resident work hours will unlikely result in a decrease health-care cost. Reduction in resident work hours has not resulted in an improvement or deterioration in patient outcome. Reduction of work hours has not increased faculty work hours nor made surgery a more attractive career choice.


CONCLUSIONS
Despite strongly held opinions, resident work-hour reduction has resulted in little significant change in lifestyle, clinical exposure, patient well-being, faculty work hours, or medical student recruitment.
Schenarts
Paul J
PJ
Department of Surgery, East Carolina University, Brody School of Medicine, Greenville, NC 27858, USA. pschenar@pcmh.com
Anderson Schenarts
Kimberly D
KD
Rotondo
Michael F
MF
D000063:Accidents, Traffic; D002321:Career Choice; D013502:General Surgery / Q000193:education*; D017048:Health Care Costs; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D009229:Mythology; D016272:Occupational Health; D015279:Organizational Culture; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D015397:Program Evaluation; D011787:Quality of Health Care; D012449:Safety; D012892:Sleep Deprivation / Q000150:complications; D020178:Sleep Disorders, Circadian Rhythm / Q000150:complications; D014481:United States; D014940:Work Schedule Tolerance