What is the Optimal Number of Working Hours for Medical Residents? Evidence from Japanese Context

The legal limit for the number of duty hours per week that medical residents are allowed to work is 80 in the USA and 48 in the European Union countries. These are the legal limits determined somehow but what is the optimal number of duty hours per week for medical residents to not cause a negative effect on their well-being and at the same time on the quality of their training?

A group of researchers looked for an answer to a part of this question in the Japanese context. They examined the number of duty hours per week of more than five thousand residents in Japan and their clinical knowledge levels.

The flamingo is ready to present this interesting article.

In Japan, 40 hours per week is the legal limit for working hours. But this limit exempted for a group of people. It was determined to be 60 hours for doctors. When it comes to medical residents, it was determined to be 80 hours per week. Around 15% of the medical residents in Japan work more than 80 hours per week. The limit will help their well-being because it will decrease their duty hours. But there are some concerns such that it may harm the quality of their training. Does less amount of time of duty hours mean less learning?

In Japan, in order to enter specialty-based training, medical students are required to take two postgraduate years after completing six years of undergraduate medical education. A group of researchers asked the medical residents what the number of duty hours per week is. These residents were either in postgraduate year one or two. The researchers also obtained the scores of the residents in a written exam that assess their clinical knowledge. A part of this exam includes video and audio questions. They compared the number of duty hours and the scores in the exam.

Here are the results.

The residents with less than 60 duty hours per week had lower scores than those with between 60 and 65 hours per week. In comparison, residents with duty hours of more than 65 hours per week did not have higher scores. These results remained same after multivariable adjustment considering the years, hospital types, number of emergency department duties, assigned inpatients, and self-study time per week.

From the perspective of clinical knowledge levels, it seems that the optimal number of duty hours is between 60 and 65 hours per week. However, it is important to note that the data about duty hours are self-reported. Residents may have not provided the real number of hours they worked and the other self-reported data. Another limitation is the scores obtained from a written test. We still don’t know what their performance in real clinical environment is. It also would be better to know their well-being, stress, and burnout levels.

Despite these limitations, it was a really good article on this topic. It has more details than I presented in this video. If you want to read more, you can find the link to the article at the description below the video: https://youtu.be/_RLYP_PvHLc

See you and adios para amigos.

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