Today’s doctor-in-training requires as much information as possible to make a confident decision, but has little time to gather it. The volume of hours worked by medical residents has been a concern for years. Resident and doctor fatigue is a significant safety and quality issue. 2011, 342: d1580-10.1136/bmj.d1580. Some specialties are very high paying, but very labor-intensive too. Australian Medical Association: Safe hours = safe patients. However, many of this latter group joined the European Union relatively recently and were not previously subject to the EWTD. Variation is seen both between countries with supposedly modern health care delivery systems and within the health systems of those countries themselves. Europe has attempted to set statutory thresholds but has succeeded in applying these in fewer than 25% of member states so far. © 2021 BioMed Central Ltd unless otherwise stated. Although Europe aims to maintain a maximum 48-hour work week for all health care workers, in North America the standard the authorities state they are trying to reduce to is 80 hours per week – the so called “safe hours.” Yet, because of the lack of any enforceable consensus, it is still not uncommon in many places for residents to work in excess of 100 hours per week. Safe and appropriate health care, especially in urgent or emergency situations, is the expectation of the public throughout the developed world. Springer Nature. The volume of hours worked by medical residents has been a concern for years. Gough IR: The impact of reduced working hours on surgical training in Australia and New Zealand. Many agree that any concerns about reductions in hours worked leading to reductions in competencies gained can be offset by better educational program design and technologies. Survey data from 1183 Norwegian physicians is employed and the empirical models are estimated by means of ordinary least squares (OLS) regression analysis, linear logit analysis, binomial logistic regression analysis and multilevel analysis. In the health care sector, the EWTD was found to affect only doctors and, more specifically, only those in the secondary care sector. Pulmonary medicine: 68 percent. Responding to A2A. The United States, Canada, and Australia are good examples of this type of process resulting in failure of agreement and progress to date. In June 2011, a Quebec labour arbitrator ruled that 24-hour continuous duty assignments pose a danger to residents’ health and therefore violate Section 7 of the Canadian Charter of Rights and Freedoms, which ensures security of the person, and Section 46 of the Quebec Charter of Rights and Freedoms, which requires “fair and reasonable conditions of employment.” The employer concerned was given 6 months to move to a system in which 16-hour shifts are the maximum allowed [6]. Each medical specialty in a hospital filled only one response for its attending physicians. Healthcare personnel — nursing professionals. If you are asking about “which specialty,” there is no one answer. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. According to … Specialty-specific Duty Hour Definitions . Begin your specialty exploration by reading the profiles of more than 135 specialties and subspecialties in the United States and the nearly 40 specialties in Canada. You need four additional years of training but you’ll have good control over working hours and very little stress. However, the process of acquiring the necessary skills was largely protracted, osmotic, patron-dependant, and quite variable in quality. The fundamental problem is that many, if not most, health care systems rely on physicians who are not yet specialists or consultants to deliver very large amounts of emergency, urgent, or repetitive service, especially in the periods out of regular office hours. The 2016 contract is safer and fairer for doctors and dentists in training and for patients. Denmark has been compliant with the EWTD for many years and has a normal work week of 37 hours. The specialties in which physicians are more likely to work 51 or more hours a week are: General surgery: 77 percent. 2011, 9 (Suppl 1): S8-9. The former system has resulted in a random, unstructured, arbitrary, and often patron-dependant method of acquiring the necessary skills to be competent for independent clinical practice. General Surgeon Working hours: 60-80 Average salary: $322,000 6. The clinical team then needs to be of sufficient size, at senior and junior levels, to allow rotas that are compliant and lead to a healthy work–life balance. The author declares he has no competing interests. Nasca TJ, Day SH, Amis ES: The new recommendations on duty hours from the ACGME Task Force. PubMed Google Scholar. Advanced Practice Providers are not far behind when it comes to how much they are working. Under these contracts it is possible for residents to work up to, and in some cases to exceed, 80 hours per week. The conclusion was reduced pay. But as far as the money/hours worked, it's one of the better paying fields out there. 9. Brensilver JM, Smith L, Lyttle CS: Impact of the Libby Zion case on graduate medical education in internal medicine. Acad Med. I understand the interest in knowing which specialty has the lowest hours worked ( i've spent many hours looking into this myself)...however one thing that I've really come to appreciate recently is that the hours you ultimately work is up to you in ANY specialty. The outcome of the newly developed ACGME standards is awaited and will be clear only in the years to come. Most physicians work between 40 and 60 hours per week, but nearly one-quarter of physicians work between 61 and 80 hours per week, according to the 2014 Work/Life Profiles of Today’s Physician released last year by AMA Insurance.. About 20 percent of responding physicians aged 60 to 69 work fewer than 40 hours per week. Currently there is no federal or provincial regulation or statute on the work hours of residents. What are the working hours and patterns a doctor can work? Compliance figures are not available for 11 countries, namely Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Italy, Luxembourg, Malta, Portugal, Slovakia, and Slovenia. Source . Sweden and Germany indicate good compliance. In view of this lack of success, renegotiation of the 48-hour restriction, along with other factors, has been requested, but it will take a very long time for any revision to be agreed, let alone put into practice. Thus, only 6 of the 27 European member states meet the prescribed standard, some 14 years after the EWTD became a legal requirement. Google Scholar, UK Department of Health: What is the European Working Time Directive?. More in Training. As expected, the surgical sub-specialties work the longest hours with neurosurgery leading the pack and general surgery following closely in second. The data is based on the workforce survey conducted by the Canadian Medical Association. The volume of hours worked by medical residents has been a concern for years. What should be the role of medical residents? Sometimes I worked at home at night—writing a paper or researching one—and sometimes I worked a few hours at home on the weekend. Most do not explicitly state a maximum number of hours per week that can be worked. If your specialty averages $250,000 per year but you typically have to work 61 hours per week, that’s $78.81 an hour. … The standards also encompass key elements necessary for effective learning and safe patient care, including new standards for supervision, transitions of care, and preparing individuals for learning and practising in teams.
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