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227 ACGME DUTY HOUR REQUIREMENTS: WHAT DO FACULTY THINK?
  1. G. M. Talente,
  2. L. J. Staton,
  3. M. R. Carroll,
  4. M. Mushtaq,
  5. L. Larsen
  1. Greenville, NC.

Abstract

Background As of July 2003, all residency programs in the United States were mandated to comply with new duty hour standards. The changes limit resident duty hours to an average of 80 hours a week and set other restrictions. The standards are proposed to help strengthen both patient care and education. We explored the attitudes of faculty regarding the impact of the changes on their quality of life, patient care, teaching, and on residency training as a whole.

Methods We conducted a cross-sectional survey of faculty in all disciplines at a university-based residency training site one year after the implementation of the new work hour rules. The survey was composed of 36 items including demographics and a Likert-scale measure of attitudes and beliefs regarding the impact of the new duty hour guidelines.

Results 99 faculty responded. Sixty-six percent of the respondents were males, 63% were tenure track faculty. Responses were received from all disciplines, with pediatrics (20%) and internal medicine (24%) having the highest percentage. Nearly all faculty were aware of the ACGME requirements (99%). Many felt problems existed with previous work hours (58%) and still existed with resident work hours (48%). In regards to quality of life respondents differed on whether the new guidelines worsened their quality of life with faculty in internal medicine, family medicine, and surgery feeling they had (p < .001). Most faculty agreed their quality of life had not improved (69%). Most reported increased patient care responsibilities (68%). In regards to patient care issues, most faculty felt patient continuity of care (73%) and resident time with their patients (75%) had decreased. They did not think medical errors were greatly affected. In regards to teaching, faculty did not agree resident training had improved (61%). Teaching was most negatively affected according to family medicine faculty (p < .05). A majority agreed that resident quality of life had improved (81%), but felt that residents would be less prepared to enter practice (60%) and that residency training as a whole was not improved (49%).

Conclusions Faculty seem to agree that the new guidelines are affecting patient continuity of care but do not seem to think medical errors are affected. Faculty feel they have increased patient care responsibilities since the implementation of the work hour guidelines and their responses suggest that they are concerned about the impact on teaching. While they feel the guidelines improve resident quality of life they do not a feel that they have improved resident education. Internal medicine, family medicine, and surgical faculty are more likely to feel the new guidelines have had a negative effect.

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