title: Pilot trial of IOM duty hour recommendations in neurology residency programs: unintended consequences.
abstract: OBJECTIVE
  To study the potential effect of the 2008 Institute of Medicine (IOM) work duty hour (WDH) recommendations on neurology residency programs.
  
  
  METHODS
  This study evaluated resident sleepiness, personal study hours, quality of life, and satisfaction and faculty satisfaction during a control month using the Accreditation Council for Graduate Medical Education WDH requirements and during an intervention month using the IOM WDH recommendations. Resident participation in both schedules was mandatory, but both resident and faculty participation in the outcome measures was voluntary.
  
  
  RESULTS
  Thirty-four residents (11 postgraduate year [PGY]-4, 9 PGY-3, and 14 PGY-2) participated. End-of-work shift sleepiness, mean weekly sleep hours, personal study hours, and hours spent in lectures did not differ between the control and intervention months. Resident quality of life measured by the Maslach Burnout Inventory declined for 1 subscore in the intervention month (p = 0.03). Resident education satisfaction declined during the intervention month for issues related to continuity of care, patient hand-offs, and knowledge of their patients. Faculty satisfaction declined during the intervention month, without a decline in quality of life.
  
  
  CONCLUSIONS
  The results from 3 residency programs suggest that the IOM WDH recommendations may negatively affect neurology resident education. This study was limited by the short duration of implementation, negative bias against the IOM recommendations, and inability to blind faculty. Additional study of the IOM WDH recommendations is warranted before widespread implementation.
authors.affiliation: Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA lschuh@neuro.hfh.edu
authors.forename: L A
authors.initials: LA
authors.lastname: Schuh
authors.forename: M A
authors.initials: MA
authors.lastname: Khan
authors.forename: H
authors.initials: H
authors.lastname: Harle
authors.forename: A M
authors.initials: AM
authors.lastname: Southerland
authors.forename: W J
authors.initials: WJ
authors.lastname: Hicks
authors.forename: A
authors.initials: A
authors.lastname: Falchook
authors.forename: L
authors.initials: L
authors.lastname: Schultz
authors.forename: G R
authors.initials: GR
authors.lastname: Finney
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000592:standards*; D008297:Male; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D009462:Neurology / Q000379:methods / Q000592:standards*; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D010865:Pilot Projects; D011446:Prospective Studies; D012892:Sleep Deprivation / Q000150:complications / Q000517:prevention & control; D014481:United States; D016526:Workload / Q000592:standards*