title: Internal medicine residents reject "longer and gentler" training.
abstract: BACKGROUND
  Increasing complexity of medical care, coupled with limits on resident work hours, has prompted consideration of extending Internal Medicine training. It is unclear whether further hour reductions and extension of training beyond the current duration of 3 years would be accepted by trainees.
  
  
  OBJECTIVE
  We aimed to determine if further work-hour reductions and extension of training would be accepted by trainees and whether resident burnout affects their opinions.
  
  
  METHODS
  A postal survey was sent to all 143 Internal Medicine residents at the University of Colorado School of Medicine in May 2004.
  
  
  METHODS
  The survey contained questions related to opinions on work-hour limits using a 5-point Likert scale ranging from strongly agree to strongly disagree. Burnout was measured using the Maslach Burnout Inventory, organized into three subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment, with burnout defined as high EE or DP.
  
  
  RESULTS
  Seventy-four percent (106/143) of residents returned the survey. The vast majority (84%) of residents disagreed or strongly disagreed with extending training to 4 or 5 years. Burnout residents were less averse to extending training (strongly agree or agree, 18.9% vs 4.3%, P = .04). The majority of residents (68.9%) disagreed or strongly disagreed with establishing a 60-hour/week limit. Residents who met the criteria for burnout were more likely to agree that a 60-hour limit would be better than an 80-hour limit (strongly agree or agree, 22% vs 8%, P = .02).
  
  
  CONCLUSIONS
  In this program, most Internal Medicine residents are strongly opposed to extending their training to 4 or 5 years and would prefer the current 80 hours/week cap. A longer, less intense pace of Internal Medicine training seems to be less attractive in the eyes of current trainees.
authors.affiliation: Division of Ambulatory Care, Department of Internal Medicine, Denver Veterans Affairs Medical Center, Denver, CO 80220, USA. Ravi.Gopal@med.va.gov
authors.forename: R K
authors.initials: RK
authors.lastname: Gopal
authors.forename: F
authors.initials: F
authors.lastname: Carreira
authors.forename: W A
authors.initials: WA
authors.lastname: Baker
authors.forename: J J
authors.initials: JJ
authors.lastname: Glasheen
authors.forename: L A
authors.initials: LA
authors.lastname: Crane
authors.forename: T J
authors.initials: TJ
authors.lastname: Miyoshi
authors.forename: A V
authors.initials: AV
authors.lastname: Prochazka
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000175:diagnosis; D003120:Colorado; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D010561:Personnel Staffing and Scheduling; D011795:Surveys and Questionnaires; D016526:Workload