title: Resident work hours.
abstract: OBJECTIVE
  The Accreditation Council for Graduate Medical Education has mandated new requirements for work hours for all US resident physicians that became effective in July 2003. Member countries of the European Union are also implementing a reduction in work hours for trainee physicians as per the European Work Time Directives. The following review provides a summary of the basis of limiting work hours for residents, steps taken towards limiting the working hours for resident doctors, and implications to residents, institutions, and states.
  
  
  RESULTS
  Reduction of work hours for physicians in training is a much awaited and necessary change. Though the framework for such a reduction is in place in most countries, implementation of the policies has been slow thus far, mainly due to financial and manpower constraints. Setting of deadlines for compliance and legislation to penalize the defaulting institutions and programs may help to put the recommendations on work hours into practice.
  
  
  CONCLUSIONS
  Long work hours contribute to stress, fatigue, and mood changes in trainee physicians that are potentially deleterious to the physician and patients. Recommendations have been made across the globe to reduce resident doctor work hours and legislation is in place to monitor institutional compliance with these recommendations. Once these regulations are complied with, follow-up studies will be needed to evaluate their effects on physician well-being and patient care.
authors.affiliation: Department of Anesthesiology, University of Washington School of Medicine, Harborview Medical Center, Seattle, Washington 98104, USA. sbhanank@u.washington.edu
authors.forename: Sanjay M
authors.initials: SM
authors.lastname: Bhananker
authors.forename: Bruce F
authors.initials: BF
authors.lastname: Cullen