title: Resident duty hours: a survey of internal medicine program directors.
abstract: BACKGROUND
  In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented new Common Program Requirements to regulate duty hours of resident physicians, with three goals: improved patient safety, quality of resident education and quality of life for trainees. We sought to assess Internal Medicine program director (IMPD) perceptions of the 2011 Common Program Requirements in July 2012, one year following implementation of the new standards.
  
  
  METHODS
  A cross-sectional study of all IMPDs at ACGME-accredited programs in the United States (N = 381) was performed using a 32-question, self-administered survey. Contact information was identified for 323 IMPDs. Three individualized emails were sent to each director over a 6-week period, requesting participation in the survey. Outcomes measured included approval of duty hours regulations, as well as perceptions of changes in graduate medical education and patient care resulting from the revised ACGME standards.
  
  
  RESULTS
  A total of 237 surveys were returned (73% response rate). More than half of the IMPDs (52%) reported "overall" approval of the 2011 duty hour regulations, with greater than 70% approval of all individual regulations except senior resident daily duty periods (49% approval) and 16-hour intern shifts (17% approval). Although a majority feel resident quality of life has improved (55%), most IMPDs believe that resident education (60%) is worse. A minority report that quality (8%) or safety (11%) of patient care has improved.
  
  
  CONCLUSIONS
  One year after implementation of new ACGME duty hour requirements, IMPDs report overall approval of the standards, but strong disapproval of 16-hour shift limits for interns. Few program directors perceive that the duty hour restrictions have resulted in better care for patients or education of residents. Although resident quality of life seems improved, most IMPDs report that their own workload has increased. Based on these results, the intended benefits of duty hour regulations may not yet have been realized.
authors.affiliation: Department of Medicine, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 593 Eddy St, JB 0100, Providence, RI, 02903, USA, mgarg@lifespan.org.
authors.forename: Megha
authors.initials: M
authors.lastname: Garg
authors.forename: Brian C
authors.initials: BC
authors.lastname: Drolet
authors.forename: Dominick
authors.initials: D
authors.lastname: Tammaro
authors.forename: Staci A
authors.initials: SA
authors.lastname: Fischer
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000592:standards* / Q000639:trends; D007396:Internship and Residency / Q000592:standards* / Q000639:trends; D008297:Male; D008875:Middle Aged; D010561:Personnel Staffing and Scheduling / Q000592:standards* / Q000639:trends; D008486:Physician Executives / Q000592:standards* / Q000639:trends; D014940:Work Schedule Tolerance / Q000523:psychology