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The 2011 ACGME Duty-Hour Requirements: A National Follow-up Survey of Family Medicine Residents

Vincent Lo*

Background and Objectives: In July 1, 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented new duty-hour and supervision requirements for all accredited residency programs. These new requirements limited post-graduate year 1 residents (PGY-1s) to 16-hour duty periods and required them to have onsite supervision. We conducted a national survey of family medicine residents to assess the impact of the new requirements. Methods: Using an online survey we assessed residents’ opinions regarding the effect of the new duty-hour requirements on patient safety, quality of care, and resident mental and physical well-being. We contacted 439 programs by email and 156 programs agreed to participate. Results: Of an estimated 3744 potential participants, 544 respondents completed the survey. Ninety-seven percent of the respondents thought that their program had implemented the new rules successfully, and 63% reported working 51-70 hours per week. Nineteen percent admitted underreporting duty hours. Fifty percent agreed that the new rules had improved resident mental and physical well-being, and forty-nine percent agreed that patient safety and quality of care improved. However, 30% disagreed that resident education and training were better. Sixty percent reported decreased clinical experience; 42% felt decreased confidence in their ability to work independently after residency. Forty-nine percent were concerned about the increase in handoffs. Conclusions: The respondents had mixed opinions about the benefits of the new duty-hour requirements in their training program. Our study found a significant gap between the intended benefits of the new dutyhour and supervision requirements and the residents’ perception of the benefits.