Residents Spend Minority of Day with Patients

While concerns that limiting residents' hours would increase mortality have proven to be unfounded, first-year residents are spending a minority of their day on actual direct patient care.

Just two years ago work hours for first-year residents was restricted to 16-hour shifts. Further restriction on the number of consecutive hours residents could work was controversial, but new studies report that work hours limits didn’t hurt patient safety.

The two studies in the Journal of General Internal Medicine revealed that no patient-safety issues have materialized as a result of limits on resident duty hours, but the residents did spend less time with patients, Modern Healthcare reported.

The purpose of the duty hour restrictions was to prevent residents being sleep deprived and more prone to errors. Critics, though, believed long hours instill professionalism. And in 2012, a study in the Annals of Surgery revealed that orthopedic residents said that while they were less fatigued, they also felt less prepared for their jobs—with the hour limits in place, they weren’t getting enough direct experience.

One study determined that, based on the duty hour restrictions for residents put in place in 2003 and again in 2011, there was no significant change in mortality just after implementation of the duty hour reform. However, mortality did improve in the fourth and fifth years after implementation.

While the authors concluded that it wasn’t clear if any improvements were a result of the reform, they said that any concerns about the duty hour reform worsening mortality outcomes were unfounded.

The other study revealed that residents spent just 12% of their time in direct patient care, which is less time than residents from studies prior to 2003.