Resident duty hours in Canada: a survey and national statement

Abstract

Physicians in general, and residents in particular, are adapting to duty schedules in which they have fewer continuous work hours; however, there are no Canadian guidelines on duty hours restrictions. To better inform resident duty hour policy in Canada, we set out to prepare a set of recommendations that would draw upon evidence reported in the literature and reflect the experiences of resident members of the Canadian Association of Internes and Residents (CAIR). A survey was prepared and distributed electronically to all resident members of CAIR. A total of 1796 eligible residents participated in the survey. Of those who responded, 38% (601) reported that they felt they could safely provide care for up to 16 continuous hours, and 20% (315) said that 12 continuous hours was the maximum period during which they could safely provide care (n = 1592). Eighty-two percent (1316) reported their perception that the quality of care they had provided suffered because of the number of consecutive hours worked (n = 1598). Only 52% (830) had received training in handover (n = 1594); those who had received such training reported that it was commonly provided through informal modelling. On the basis of these data and the existing literature, CAIR recommends that resident duty hours be managed in a way that does not endanger the health of residents or patients; does not impair education; is flexible; and does not violate ethical or legal standards. Further, residents should be formally trained in handover skills and alternative duty hour models.

Comparison of Canadian and Swiss Surgical Training Curricula: Moving on Toward Competency-Based Surgical Education

“…In contrast, Basel residents are subject to a much stricter RDHR with less formal training time. This fact may be seen as a less favorable environment for optimal surgical training quality, confirming articulated concerns and findings of other studies [9][10][11]14,21,40 . However, deployment of alternative working patterns can help to overcome this shortcoming 13 , without decline in surgical competence 15 .…”

“…Queen's residents work significantly longer compared to their Basel colleagues, reflecting the findings of other studies 17,21 . However, especially consultants at both Queen's and Basel expressed concern about the impact of RDHR on the number of performed surgical procedures, a finding reported in other studies [9][10][11]14,21,40 . As a consequence, the majority of Swiss' and Queen's surgical residents self-reported that they circumnavigated the imposed RDHR by "volunteering" for additional work hours.…”

Prevalence and predictors of burnout among obstetrics and gynecology residents in Canada

“…There have been no Canadian guidelines on duty hour restrictions [11]. However, each province has its own regulations.…”

Problem niedoboru lekarzy — czy jest na to remedium?

“…Argument, że lekarze nie chcą pracować ponad swoje możliwości, jest zrozumiały, ale musi zostać skonfrontowany z wymaganiami systemowymi, albowiem zbyt mała liczba lekarzy wiąże się z ryzykiem dla pacjentów. Z powodu braku rozwiązań legislacyjnych problem pozostaje nierozwiązany [23][24][25].…”