A systematic review published in the British Medical
Journal found that reducing doctors’ working time to less than 80
hours a week does not seem to adversely affect patient safety and has limited
impact on post-graduate medical training in the US, according to a press
The study, led by S. Ramani Moonesinghe, an anesthesiology consultant
and honorary senior lecturer at the University College Hospital in London, and
colleagues sought to evaluate the impact of work reduction on educational and
clinical outcomes by reviewing 72 studies published in the UK
“The impact of reducing hours to less than 56 or 48 a week in the
UK has not been sufficiently evaluated in high-quality studies,” the
researchers wrote. “Further work is required, particularly in the European
Union, using large, multicenter evaluations of the impact of duty hours’
legislation on objective educational and clinical outcomes.”
Of the studies reviewed, 38 reported on training outcomes, 31 noted
patient outcomes and three studies reported on both types of outcomes.
The maximum hours per week for
trainees can range from 37 hours in Denmark to 80 hours in
the US. The European Working Time Directive, initiated in 2004, restricted the
weekly training period for doctors in Europe to 48 hours. Since that time,
there has been concern in the medical profession about potential adverse
effects on postgraduate training for junior doctors and the provision of
high-quality care for patients, according to the release.
The authors noted that more high-quality studies are needed to evaluate
the impact of restricting work hours using objective measures of medical
training and patient safety, particularly in the European Union, according to
the release. “Only then can both the public and the profession be
reassured that the standard of medical training, and therefore the future care
of patients, is of the highest possible quality and will be maintained or
improved over time,” they concluded.
Disclosure: Moonesinghe has no relevant financial disclosures.