May 28th, 2015
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A Resitern's Reflections on Duty-Hours ReformLast winter, as a third-year resident, I hosted an informal Q&A session for applicants to my internal-medicine residency program. A group of crisply suited fourth-year medical students were gathered around asking typical applicant questions: What do you like about it? Are people nice? Is there parking? Then, one applicant asked me about the wards schedule, noting that ours was the only program in the area that still mandated overnight call for interns. I was so surprised to hear it that I burst out laughing. Quickly apologizing, I tried to explain: even since I was in your seat a few years ago, I told her, things have changed so much. She replied that she knew that working intermittent overnight shifts isn't healthy. I agreed with her. And the fact is that I do agree although that system may actually be better for patients1 and yet I was flabbergasted at her expectations of her intern year and at her openness about revealing them.Many of my predecessors viewed the 2003 duty-hour regulations as excessively restrictive and coddling. Similarly, the new cultural norms taking shape around the latest duty-hours overhaul have been difficult to internalize for those of us who completed our intern year under the most recent old system. My first year of residency, the majority of the workload still fell on interns, who worked more hours than almost anyone else in the hospital. Furthermore, interns had a substantial amoun

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