Shorter Residency Training Did not Lead to Lower-Quality Physicians
Shortening residency training did not lead to lower-quality physicians, a new study reported. In 2013, due to concerns regarding medical errors, the amount of time residents worked per week was capped at 80 hours. The amount of hours that the residents could work consecutively was also capped at 30. Despite these cuts, the researchers concluded that physician training was not jeopardized.
For this study, Anupam Jena, assistant professor of health care policy at Harvard Medical School and colleagues at Stanford School of Medicine examined data on four million patients from Florida. The data encompassed the time frame from 2000 to 2009. The researchers measured physician quality based on their patients' length of hospital stay as well as the rate of inpatient mortality.
"This is perhaps the most hotly debated question in medical education. With many believing that doctors trained with fewer hours are less well-prepared for independent practice after the completion of residency," Jena said according to Medical Xpress. "A major reason why we have no evidence on the long-term effects of duty-hour reductions on the quality of physicians completing residency is that data linking patient outcomes to physician training history has simply been unavailable."
This study found that the hospital mortality rates were similar between physicians who were trained prior to the changes in working hours and physicians who were trained after the cuts were made (3.3 percent versus 3.2 percent). High-risk patients who were treated by physicians trained after 2006, when the cuts were already made, had better outcomes in comparison to the patients who were treated by physicians trained in 2003 or earlier.
Even though the study did not find a cause and effect relationship, the findings suggest that shorter work hours could actually improve physician care in some areas. The researchers noted that they only measured mortality rates even though other factors, such as readmissions rates and procedural outcomes could reveal more information regarding the effects of shorter work hours. However, information on other factors was not available.
"Mortality, however, is the first and most important measure to evaluate, although there are many other things to consider," Jena said. "We are just scratching the surface."
The study was published in Health Affairs.