0
Correspondence |

Effect of Work Hour Restrictions on Fellows FREE TO VIEW

Maria Lucarelli, MD, MS; John Mastronarde, MD; Gary Phillips, MS; Catherine Lucey, MD
Author and Funding Information

Affiliations: Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine,  Center for Biostatistics,  Department of Internal Medicine, Ohio State University Medical Center, Columbus, OH

Correspondence to: Maria Lucarelli, MD, MS, The Ohio State University Medical Center, 473 W 12th Ave, Columbus, OH 43210; e-mail: maria.lucarelli@osumc.edu



Chest. 2007;131(5):1614. doi:10.1378/chest.07-0345
Text Size: A A A
Published online

To the Editor:

In 2003, the Accreditation Council for Graduate Medical Education began enforcing the 80-h work week for residents. While work hour restrictions (WHR) have had beneficial effects on resident well-being and fatigue, unintended effects of these changes are beginning to emerge.12 The effects on fellow trainees has not been evaluated.

We sent an anonymous Internet-based survey via e-mail to fellowship directors identified on the American Thoracic Society Web page. The directors were asked to forward the survey link to their fellows. A total of 125 responses were received.

Most fellows reported no impact or a negative impact of WHR on fellow quality of life (58%), personal life (57%), and sleep (59%). Fellows report doing more resident-level duties (58%) and procedures (49%), with less time to teach residents and students (43%). Strikingly, 26% report a negative impact of WHR on fellow education.

These data suggest that WHR have significant effects on pulmonary and critical care fellow training. In contrast to other studies35 that have demonstrated a substantial improvement in quality of life of residents after WHR, this does not appear to be the case for fellows. The lack of improvement may be due to a shift in duties traditionally performed by residents to fellows. Previous reports45 of resident dissatisfaction with WHR have been related to decreased interactions with attending physicians, decreased educational opportunities, and an increase in more junior trainee-level responsibility. It may be this shift in resident duties to fellows that is a significant factor for the negative view of WHR among fellows. These preliminary data argue for further large-scale studies of the impact of WHR on fellow education and patient care outcomes, as current approaches to fellow education may need to be adjusted due to WHR.

The authors have no conflicts of interest to disclose.

Coverdill, JE, Finlay, W, Adrales, GL, et al (2006) Duty-hour restrictions and the work of surgical faculty: results of a multi-institutional study.Acad Med81,50-56. [PubMed] [CrossRef]
 
Winslow, ER, Berger, L, Klingensmith, ME Has the 80-hour work week increased faculty hours?Curr Surg2004;61,602-608. [PubMed]
 
Barden, CB, Specht, MC, McCarter, MD, et al Effects of limited work hours on surgical training.J Am Coll Surg2002;195,531-538. [PubMed]
 
Lin, GA, Beck, DC, Garbutt, JM Residents’ perceptions of the effects of work hour limitations at a large teaching hospital.Acad Med2006;81,63-67. [PubMed]
 
Zuckerman, JD, Kubiak, EN, Immerman, I, et al The early effects of code 405 work rules on attitudes of orthopaedic residents and attending surgeons.J Bone Joint Surg Am2005;87,903-908. [PubMed]
 

Figures

Tables

References

Coverdill, JE, Finlay, W, Adrales, GL, et al (2006) Duty-hour restrictions and the work of surgical faculty: results of a multi-institutional study.Acad Med81,50-56. [PubMed] [CrossRef]
 
Winslow, ER, Berger, L, Klingensmith, ME Has the 80-hour work week increased faculty hours?Curr Surg2004;61,602-608. [PubMed]
 
Barden, CB, Specht, MC, McCarter, MD, et al Effects of limited work hours on surgical training.J Am Coll Surg2002;195,531-538. [PubMed]
 
Lin, GA, Beck, DC, Garbutt, JM Residents’ perceptions of the effects of work hour limitations at a large teaching hospital.Acad Med2006;81,63-67. [PubMed]
 
Zuckerman, JD, Kubiak, EN, Immerman, I, et al The early effects of code 405 work rules on attitudes of orthopaedic residents and attending surgeons.J Bone Joint Surg Am2005;87,903-908. [PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543