title: Effects of the 2011 duty hour reforms on interns and their patients: a prospective longitudinal cohort study.
abstract: OBJECTIVE
  In 2003, the first phase of duty hour requirements for US residency programs recommended by the Accreditation Council for Graduate Medical Education (ACGME) was implemented. Evidence suggests that this first phase of duty hour requirements resulted in a modest improvement in resident well-being and patient safety. To build on these initial changes, the ACGME recommended a new set of duty hour requirements that took effect in July 2011.
  
  
  OBJECTIVE
  To determine the effects of the 2011 duty hour reforms on first-year residents (interns) and their patients.
  
  
  METHODS
  As part of the Intern Health Study, we conducted a longitudinal cohort study comparing interns serving before (2009 and 2010) and interns serving after (2011) the implementation of the new duty hour requirements.
  
  
  METHODS
  Fifty-one residency programs at 14 university and community-based GME institutions.
  
  
  METHODS
  A total of 2323 medical interns.
  
  
  METHODS
  Self-reported duty hours, hours of sleep, depressive symptoms, well-being, and medical errors at 3, 6, 9, and 12 months of the internship year.
  
  
  RESULTS
  Fifty-eight percent of invited interns chose to participate in the study. Reported duty hours decreased from an average of 67.0 hours per week before the new rules to 64.3 hours per week after the new rules were instituted (P < .001). Despite the decrease in duty hours, there were no significant changes in hours slept (6.8 → 7.0; P = .17), depressive symptoms (5.8 → 5.7; P = .55) or well-being score (48.5 → 48.4; P = .86) reported by interns. With the new duty hour rules, the percentage of interns who reported concern about making a serious medical error increased from 19.9% to 23.3% (P = .007).
  
  
  CONCLUSIONS
  Although interns report working fewer hours under the new duty hour restrictions, this decrease has not been accompanied by an increase in hours of sleep or an improvement in depressive symptoms or well-being but has been accompanied by an unanticipated increase in self-reported medical errors.
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA. srijan@umich.edu
authors.forename: Srijan
authors.initials: S
authors.lastname: Sen
authors.forename: Henry R
authors.initials: HR
authors.lastname: Kranzler
authors.forename: Aashish K
authors.initials: AK
authors.lastname: Didwania
authors.forename: Ann C
authors.initials: AC
authors.lastname: Schwartz
authors.forename: Sudha
authors.initials: S
authors.lastname: Amarnath
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Kolars
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Dalack
authors.forename: Breck
authors.initials: B
authors.lastname: Nichols
authors.forename: Constance
authors.initials: C
authors.lastname: Guille
mesh_terms: D000068:Accreditation; D000328:Adult; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D007588:Job Satisfaction; D008137:Longitudinal Studies; D008297:Male; D019300:Medical Errors; D010561:Personnel Staffing and Scheduling; D011446:Prospective Studies; D012890:Sleep; D014940:Work Schedule Tolerance; D016526:Workload / Q000523:psychology / Q000592:standards*