Am J Med

BackgroundIn 2011, the Accreditation Council for Graduate Medical Education (ACGME) instituted a 16-h limit on consecutive hours for first-year resident physicians. We sought to examine the effect of these work-hour regulations on physician safety.MethodsAll medical students matched to a United States residency program from 2002\u20132007 and 2014\u20132017 were invited to participate in prospective cohort studies. Each month participants reported hours of work, extended duration shifts, and adverse safety outcomes; including motor vehicle crashes , percutaneous injuries, and attentional failures. The incidence of each outcome was compared before and after the 2011 ACGME work-hour limit. Hypotheses were tested using generalized linear models adjusted for potential confounders.Results13% of all first-year resident physicians nationwide participated in the study, with 80,266 monthly reports completed by 15,276 first-year resident physicians. Following implementation of the 16-h 2011 ACGME work-hour limit, the mean number of extended duration ( 6524-h) shifts per month decreased from 3.9 to 0.2. The risk of motor vehicle crash decreased 24% (RR 0.76; 0.67\u20130.85), percutaneous injury risk decreased more than 40% (RR 0.54; 0.48\u20130.61), and the rate of attentional failures was reduced 18% (IRR 0.82; 0.78\u20130.86). Extended duration shifts and prolonged weekly work hours were associated with an increased risk of adverse safety outcomes independent of cohort.ConclusionsThe 2011 ACGME work-hour limit was associated with meaningful improvements in physician safety and health. Surveillance is needed to monitor the ongoing impact of work hours on physician safety, health, and well-being.20202021-07-01T00:00:00ZT32 HL007901/HL/NHLBI NIH HHS/United StatesR01 OH010300/OH/NIOSH CDC HHS/United StatesF32 HL134249/HL/NHLBI NIH HHS/United StatesR01 OH007567/OH/NIOSH CDC HHS/United StatesR01 OH011773/OH/NIOSH CDC HHS/United StatesU01 HL111478/HL/NHLBI NIH HHS/United States32061733PMC7469904832