title: Anticipated consequences of the 2011 duty hours standards:  views of internal medicine and surgery program directors.
abstract: OBJECTIVE
  To assess internal medicine (IM) and surgery program directors' views of the likely effects of the 2011 Accreditation Council for Graduate Medical Education duty hours regulations.
  
  
  METHODS
  In fall 2010, investigators surveyed IM and surgery program directors, assessing their views of the likely impact of the 2011 duty hours standards on learning environment, workload, education opportunities, program administration, and patient outcomes.
  
  
  RESULTS
  Of 381 IM program directors, 287 (75.3%) responded; of 225 surgery program directors, 118 (52.4%) responded. Significantly more surgeons than internists indicated that the new regulations would likely negatively impact learning climate, including faculty morale and residents' relationships (P < .001). Most leaders in both specialties (80.8% IM, 80.2% surgery) felt that the regulations would likely increase faculty workload (P = .73). Both IM (82.2%) and surgery (96.6%) leaders most often rated, of all education opportunities, first-year resident clinical experience to be adversely affected (P < .001). Respondents from both specialties indicated that they will hire more nonphysician/midlevel providers (59.5% IM, 89.0% surgery, P < .001) and use more nonteaching services (66.8% IM, 70.1% surgery, P = .81). Respondents expect patient safety (45.1% IM, 76.9% surgery, P < .001) and continuity of care (83.6% IM across all training levels, 97.5% surgery regarding first-year residents) to decrease.
  
  
  CONCLUSIONS
  IM and surgery program directors agree that the 2011 duty hours regulations will likely negatively affect the quality of the learning environment, workload, education opportunities, program administration, and patient outcomes. Careful evaluation of actual impact is important.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6021, USA. sheaja@mail.med.upenn.edu
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Willett
authors.forename: Karen R
authors.initials: KR
authors.lastname: Borman
authors.forename: Kamal M F
authors.initials: KM
authors.lastname: Itani
authors.forename: Furman S
authors.initials: FS
authors.lastname: McDonald
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Call
authors.forename: Saima
authors.initials: S
authors.lastname: Chaudhry
authors.forename: Michael
authors.initials: M
authors.lastname: Adams
authors.forename: Karen M
authors.initials: KM
authors.lastname: Chacko
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Volpp
authors.forename: Vineet M
authors.initials: VM
authors.lastname: Arora
mesh_terms: D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards*; D005180:Faculty, Medical; D013502:General Surgery / Q000193:education* / Q000592:standards; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000592:standards; D007396:Internship and Residency / Q000592:standards*; D061214:Patient Safety / Q000592:standards; D011795:Surveys and Questionnaires; D014481:United States; D016526:Workload / Q000592:standards*