In 1995, the Australian Medical Association launched its Safe Working Hours campaign. By 1998, this had been developed into a National Code of Conduct that continues to resonate in the Australian public health system. However, and particularly in respect of Doctors in Training (DITs) who continue to work long hours, there are levels of resistance to proposals that seek to re-organise work or change prevailing professional and cultural expectations. Long working hours have substantial impacts on a DIT's capacity to consistently deliver high quality patient care, dilute the effectiveness of their training regime and have negative consequences on their health, social life and family responsibilities. While public hospitals often maintain the view that minimal budget flexibility restricts their capacity to affect change in a positive way, in fact devisable productivity and efficiency gains can be achieved by reducing working hours. Further, the medical profession needs to consider whether long hours provide an optimal environment for quality learning and performance.