The impact of the implementation of work hour requirements on residents' career satisfaction, attitudes and emotions

A validated survey instrument was used to assess residents' levels of career satisfaction, emotions and attitudes before and after the ACGME duty hour requirements were implemented. The "pre" implementation survey was distributed in December 2002 and the "post" implementation one in December 2004. Only the latter included work-hour related questions.The response rates were 56% for the 2002 and 72% for the 2004 surveys respectively. Although career satisfaction remained unchanged, numerous changes occurred in both emotions and attitudes. Compared to those residents who did not violate work-hour requirements, those who did were significantly more negative in attitudes and emotions.With the implementation of the ACGME work hour limitations, the training experience became more negative for those residents who violated the work hour limits and had a small positive impact on those who did not violate them. Graduate medical education leaders must innovate to make the experiences for selected residents improved and still maintain compliance with the work hour requirements.The Accreditation Council for Graduate Medical Education (ACGME) implemented residents' work hour limitations in July 2003 to improve patient safety. Another important potential impact of more limited work hours is change in residents' career satisfaction. Virtually all studies of residents' career satisfaction, emotions and attitudes at mid year have demonstrated negative findings, many of which have been reported in studies from this institution and from collaborations with others [1-14]. Indeed, many authors have proposed that excessive work hours have been at least to a degree responsible for those negative findings [3,5,6,12-15]. Thus one would intuitively think that fewer hours of duty might result in more favorable feelings about career satisfaction, emotions and attitudes.This study utilized a survey instrument, previously validated to demonstrate changes in attitudes and emotions with the Profile