Internal medicine housestaff and attending physician perceptions of the impact of the New York State section 405 regulations on working conditions and supervision of residents in two training programs

Abstract

Housestaff had more positive attitudes about the impact of the mandated changes in working conditions for residents than did attending physicians in the same institutions. The major benefits seen by residents were less fatigue and more spare time. There was no consensus about whether these changes had a positive impact on internal medicine practice and clinical supervision. There was some concern that a shift-work mentality is developing among residents and that continuity of patient care has suffered. Thus, despite some substantial benefits, Section 405 may not be achieving its goals of improving resident supervision and the quality of patient care by houseofficers.

Tired cops: probable connections between fatigue and the performance, health and safety of patrol officers

“…Under the New York State Health Code (revised Section 405), which has been copied widely (Kelly et al, 1991), residents in emergency departments now are limited to 12-hour shifts. Those in other hospital departments may not average more than 80 hours per week over a four-week period and they may not work more than 24 hours consecutively, with at least a 24-hour period of non-working time each week (Conigliaro et al, 1993).…”

On-call work and health: a review

“…New working regulations have been introduced in an attempt to deal with what is considered, by many, to be harsh and unacceptable working conditions. The debate over and outcome of these interventions continues [8-10]. …”

Medical Education and the ACGME Duty Hour Requirements: Assessing the Effect of a Day Float System on Educational Activities

“…4 Studies in New York, which has a 14-year history of having state-regulated duty hour limits for residents, have shown that duty hour limits reduced resident fatigue and allowed more time for reading and for personal pursuits with little change in in-service exam scores and quality of patient care. 5,6 More recently, two studies have demonstrated that limiting intern work shifts during an Intensive Care Unit rotation decreased medical errors. 7,8 Those involved in graduate medical education, however, have long struggled with competing priorities that surround the issue of resident service versus education.…”