Pediatric residents' perspectives on reducing work hours and lengthening residency: a national survey.
OBJECTIVE
In 2011, the Accreditation Council on Graduate Medical Education increased restrictions on resident duty-hours. Additional changes have been considered, including greater work-hours restrictions and lengthening residency. Program directors tend to oppose further restrictions; however, residents' views are unclear. We sought to determine whether residents support these proposals, and if so why.


METHODS
We surveyed US pediatric residents from a probability sample of 58 residency programs. We used multivariate logistic regression to determine predictors of support for (1) a 56-hour workweek and (2) the addition of 1 year to residency to achieve a 56-hour week.


RESULTS
Fifty-seven percent of sampled residents participated (n = 1469). Forty-one percent of respondents supported a 56-hour week, with 28% neutral and 31% opposed. Twenty-three percent of all residents would be willing to lengthen training to reduce hours. The primary predictors of support for a 56-hour week were beliefs that it would improve education (odds ratio [OR] 8.6, P < .001) and quality of life (OR 8.7, P < .001); those who believed patient care would suffer were less likely to support it (OR 0.10, P < .001). Believing in benefits to education without decrement to patient care also predicted support for a 56-hour-week/4-year program.


CONCLUSIONS
Pediatric residents who support further reductions in work-hours believe reductions have positive effects on patient care, education, and quality of life. Most would not lengthen training to reduce hours, but a minority prefers this schedule. If evidence mounts showing that reducing work-hours benefits education and patient care, pediatric residents' support for the additional year may grow.
aDivision of General Pediatrics, Children’s Hospital Boston, Boston, Massachusetts 02115, USA. mbwgordon@gmail.com
Mary Beth
MB
Gordon
Theodore C
TC
Sectish
Marc N
MN
Elliott
David
D
Klein
Christopher P
CP
Landrigan
Laura M
LM
Bogart
Stephen
S
Amrock
Ann
A
Burke
Vincent W
VW
Chiang
Mark A
MA
Schuster
D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010372:Pediatrics / Q000193:education*; D010820:Physicians / Q000523:psychology*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D016526:Workload