Effects of resident work hour limitations on faculty professional lives

Abstract

Background: The Accreditation Council for Graduate Medical Education resident work hour limitations were implemented in July, 2003. Effects on faculty are not well understood.

Objective: The objective of this study was to determine the effects of the resident work hour limitations on the professional lives of faculty physicians.

Design and participants: Survey of faculty physicians at three teaching hospitals associated with university-based internal medicine and surgery residency programs in Seattle, Washington. Physicians who attended on Internal Medicine and Surgery in-patient services during the 10 mo after implementation of work hour limitations were eligible for participation (N = 366); 282 physicians (77%) returned surveys.

Measurements: Participants were asked about the effects of resident work hour limitations on aspects of their professional lives, including clinical work, research, teaching, and professional satisfaction.

Results: Most attending physicians reported that, because of work hour limitations, they spent more time on clinical work (52%), felt more responsibility for supervising patient care (65%), and spent less time on research or other academic pursuits (51%) and teaching residents (72%). Reported changes in work content were independently associated with the self-reported probability of leaving academic medicine in the next 3 y.

Conclusions: Resident work hour limitations have had large effects on the professional lives of faculty. These findings may have important implications for recruiting and retaining faculty at academic medical centers.

Figure 1

Reported effects of work hour limitations on professional life. The figure shows the proportion of respondents for Surgery (S) and Internal Medicine (IM) reporting effects of work hour limitations on aspects of professional life. The blue bars represent the proportion reporting an increase because of the work hour limitations, the red bars represent the proportion reporting no change, and the yellow bars represent the proportion reporting a decrease. * p ≤ 0.05 for surgery vs medicine.

Figure 2

Additional clinical work hours reported by attending physicians. The figure shows the distribution of additional clinical hours reported by attending physicians. Red bars indicate the percent of total respondents reporting an increase “mostly or entirely because of WHLs, blue bars indicate those reporting an increase “partly” because of WHLs. The yellow bars indicate those reporting an increase not attributed to WHLs.