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: firstname.lastname@example.org
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.1–2 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 studies3–5 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 reports4–5 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.
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