title: Resident duty-hour restrictions-who are we protecting?: AOA critical issues.
abstract: As advocated by Nasca, our teaching programs must nurture professionalism and the effacement of self interest that is the core of the practice of medicine and the profession. The evidence to date suggests that work-hour restrictions based solely on clock-defined time limits discourage, rather than promote, the professional behavior that we desire in tomorrow's physicians. Notwithstanding any issues related to duty hours or fitness for duty, a competency-based system of medical education is both desirable and necessary in the current environment of medical education. In the absence of evidence to suggest that duty-hour limits reduce medical errors and enhance patient safety, and until we have evolved to a competency-based system of resident education, a misguided and overzealous focus on limiting work hours should not be allowed to exert the unintended consequence of eroding the ethos of professionalism that we, and our patients, have come to expect of a physician.
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, 676 North St. Clair, Suite 1350, Chicago, IL 60611, USA. tpeabody@nmff.org
authors.forename: Terrance
authors.initials: T
authors.lastname: Peabody
authors.forename: Steven
authors.initials: S
authors.lastname: Nestler
authors.forename: Clare
authors.initials: C
authors.lastname: Marx
authors.forename: Vincent
authors.initials: V
authors.lastname: Pellegrini
mesh_terms: D000068:Accreditation; D000328:Adult; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000458:organization & administration; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D019300:Medical Errors / Q000517:prevention & control*; D061214:Patient Safety; D010561:Personnel Staffing and Scheduling / Q000331:legislation & jurisprudence*; D014481:United States; D014940:Work Schedule Tolerance; D016526:Workload / Q000331:legislation & jurisprudence*