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Effects of Resident Work Hour Limitations on Faculty Professional Lives

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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.

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Acknowledgements

The authors thank the attending physicians at UW-affiliated hospitals and Drs. William J. Bremner, Joyce E. Wipf, Carlos A. Pellegrini, and Karen D. Horvath for their support. They thank Ms. Tetana E. Oguara and Ms. Siobhan C. Brown for their technical assistance. Dr. Goitein thanks Drs. Leonard D. Hudson and Diane P. Martin for their mentorship. Investigators received salary support from their institutions and grant support as described below, but these sources were not involved in design and conduct of the study; in collection, management, analysis, and interpretation of data; or in preparation, review, or approval of the manuscript. During this research, Dr. Goitein was a fellow in Pulmonary/Critical Care Medicine at the University of Washington in Seattle, and received a National Research Service Award training grant from the Agency for Healthcare Research and Quality. Dr. Shanafelt is Assistant Professor of Medicine and received institutional support from the Mayo Clinic in Rochester, MN. During this research, Dr. Nathens was Associate Professor of Surgery in the Division of Trauma and General Surgery at the University of Washington, and received institutional support from Harborview Medical Center. Dr. Curtis is Professor of Medicine in the Division of Pulmonary and Critical Care at the University of Washington and was funded by a K24 Award from the National Heart Lung and Blood Institute. None of the authors had financial conflicts of interest. Dr. Goitein had full access to all the data and takes responsibility for its integrity and the accuracy of the analysis. In addition to salary support from individual institutions, Dr. Goitein received support from a National Research Service Award training grant from the Agency for Healthcare Research and Quality, and Dr. Curtis received support from a K24 Award from the National Heart Lung and Blood Institute.

Conflict of Interest

None disclosed.

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Authors

Corresponding author

Correspondence to Lara Goitein MD.

Appendix

Appendix

Selected Survey Questions

Table 5 Survey Questions Concerning Perceived Effects of Work Hour Limitations on Professional Life, and a Separate Survey Question About Overall Likelihood of Leaving Academic Medicine

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Goitein, L., Shanafelt, T.D., Nathens, A.B. et al. Effects of Resident Work Hour Limitations on Faculty Professional Lives. J GEN INTERN MED 23, 1077–1083 (2008). https://doi.org/10.1007/s11606-008-0540-1

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