Cuts in Trainee Doctor Hours Haven't Harmed Patients

Cutting back on the grueling hours that U.S. medical residents spend in training doesn't translate into poorer care, new research shows.

When training hours were capped at 80 hours a week in 2003, some critics said it would harm medical residents' preparedness to practice.

"This is probably the most hotly debated topic in medical education among physicians," said study lead author Dr. Anupam Jena, an associate professor of health care policy at Harvard Medical School.

"Many doctors trained under the old system think that today's residents don't get enough training under the new system. You hear a lot of senior physicians looking at younger doctors coming out of training and saying, 'They're not as prepared as we were,'" said Jena, a physician in the department of medicine at Massachusetts General Hospital.

But the researchers found differently.

They analyzed nearly 486,000 hospitalizations of Medicare patients before and after the training hours cap was implemented and found no evidence that it had any impact on the quality of care delivered by new physicians.

The study found there were no significant differences in 30-day deaths, 30-day hospital readmissions, or inpatient spending between physicians who completed their residency before and after the training hours cap.

For example, 30-day death rates among patients cared for by first-year attending internists during 2000-2006 and 2007-2012 were 10.6% and 9.6%, respectively.

To compare, the 30-day death rates among patients cared for by tenth-year attending physicians were 11.2% during 2000-2006 and 10.6% during 2007-2012.

Hospital readmission rates were 20.4% for patients cared for by first-year physicians in both 2000-2006 and 2007-2012, compared with 20.1% and 20.5%, respectively, among patients treated by senior physicians.

"We found no evidence that the care provided by physicians who trained under the 80-hour-a-week model is suboptimal," Jena said in a Harvard news release.

The study was published in the BMJ.

The cap of 80 hours a week was implemented after a number of high-profile patient injuries and deaths believed to be due to clinical errors caused by medical resident fatigue.

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