The impact of 2011 duty hours requirements on family medicine residents.

Background And Objectives: Our objective was to determine family medicine residents' perception of changes in education, patient care, and quality of life following implementation of the 2011 Accreditation Council of Graduate Medical Education (ACGME) Common Program Requirements.

Methods: Designated institutional officials at all 682 ACGME-accredited institutions were contacted and asked to distribute an anonymous, electronic survey to all residents at each sponsoring institution. The survey was administered to 2,956 family medicine residents at 61 institutions between December 2011 and February 2012.

Results: A large, demographically representative sample of residents (n=928) was identified as training in family medicine. Nearly half of residents (47.4%) reported disapproval of the duty hour requirements, with less than a quarter reporting approval (24.6%). Only quality of life for interns was identified as improved by a majority of respondents (63.3%). Meanwhile, quality of life for senior residents was generally reported as worse (53.0%). Likewise, a plurality of respondents stated that both quality of resident education (43.4%) and work schedules (47.9%) were negatively impacted, while more than half (56.5%) reported that preparation for more senior roles was worse. Aspects felt to be unchanged included amount of rest (45.4%) and hours worked by residents (52.8%). Although most respondents (52.0%) felt that safety of care was unchanged, more (77.9%) reported an increase in hand-offs and no increase in the availability of supervision (72.2%). Finally, the majority of residents (68.5%) agreed that there has been a shift of junior level responsibilities to more senior residents.

Conclusions: It appears that family medicine residents generally disapprove of the 2011 ACGME duty hour regulations. They report negative consequences including a shift of intern responsibility to senior residents, as well as decreased preparedness for more senior roles. Further, patient safety, availability of supervision, and quality of education seem to be unimproved or worse.