title: Beyond work-hour restrictions: a qualitative study of residents' subjective workload.
abstract: BACKGROUND
  Following the introduction of work-hour restrictions, residents' workload has become an important theme in postgraduate training. The efficacy of restrictions on workload, however, remains controversial, as most research has only examined objective workload. The purpose of this study was to explore the less clearly understood component of subjective workload and, in particular, the factors that influenced residents' subjective workload.
  
  
  METHODS
  This study was conducted in Japan at three community teaching hospitals. We recruited a convenience sample of 31 junior residents in seven focus groups at the three sites. Audio-recorded and transcribed data were read iteratively and analyzed thematically, identifying, analyzing and reporting themes within the data and developing an interpretive synthesis of the topic.
  
  
  RESULTS
  Seven factors influenced residents' subjective workload: (1) interaction within the professional community, (2) feedback from patients, (3) being in control, (4) professional development, (5) private life, (6) interest and (7) protected free time.
  
  
  CONCLUSIONS
  Our findings indicate that residents who have good interaction with colleagues and patients, are competent enough to control their work, experience personal development through working, have greater interest in their work, and have fulfilling private lives will have the least subjective workload.
authors.affiliation: Center for Medical Education, Kyoto University, Yoshida-konoe- cho, Sakyo-ku, 606-8501, Kyoto, Japan. hiroshi.nishigori@gmail.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishigori
authors.affiliation: Center for Clinical Epidemiology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Gautam A
authors.initials: GA
authors.lastname: Deshpande
authors.affiliation: Department of General Internal Medicine, Okinawa Chubu Hospital, Okinawa, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Obara
authors.affiliation: Center for Clinical Epidemiology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahashi
authors.affiliation: Educational Development and Research Department, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherland.
authors.forename: Jamiu
authors.initials: J
authors.lastname: Busari
authors.affiliation: Educational Development and Research Department, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherland.
authors.forename: Tim
authors.initials: T
authors.lastname: Dornan