On 15 December 2008, the Institute of Medicine published a consensus report entitled Resident Duty Hours: Enhancing Sleep, Supervision, and Safety[ 8], designed to optimize graduate medical trainee hours and work schedules to improve patient safety.
In the UK, trainees spend hours practising "breaking bad news" while expressions of emotion are reserved for special side rooms.
Of course, the study was small and closely monitored, and so it's still unclear whether better handoffs will really mitigate the side effects of cutting trainees' work hours in the real world.
Consultant physicians as well as surgeons expressed concerns that, in the long term, the cumulative effect of the reduction in trainees' working hours would be a new generation of consultants who lacked the confidence and competence for independent practice, with the possible erosion of standards of patient care (see comment S12 in the online supplementary file from a general practice principal).
In fact, Landrigan's seminal study succeeded precisely because he didn't merely shorten trainee work hours.
The results, published last year, were equally sobering and showed that roughly a fifth of all hospitalized patients suffered harm from medical errors; cutting trainee work hours had no impact.
A case study of all the training process of one trainee (38 hours) was carried out in real world.
Two important changes in the past decade have altered the landscape of graduate medical education (GME) in the U.S. The national restrictions on trainee duty hours mandated by the Accreditation Council for Graduate Medical Education (ACGME) were the most visible and generated much controversy.
Recognition that physician distress negatively impacts both physician and patient has led to several recent reforms in the physician training process, including regulation of trainee duty hours [ 74- 76].
Additionally, while trainee duty hours have been reduced, few academic centers have the financial means to hire additional providers to complete the work previously performed by residents and fellows.
