When I first seriously began discussing the possibility of applying to medical school with my family and close friends, I received mixed reactions. Although medicine seemed like a great fit for me in many ways, I also heard sad stories about relationships and even entire families that had struggled to survive the strenuous period of medical training (particularly residency). As somebody who values family and close relationships highly, I was naturally concerned by this and thought about my decision very carefully. Ultimately, I decided that the rewarding nature of a medical career would make the challenges and sacrifices more than worth it in the long run.
Recently, however, these earlier thoughts about personal well-being during medical training returned to mind when a study designed to evaluate the effects of longer shifts for residents was released. The authors compared the current shift restrictions (which are set by a national council) with so-called “flexible” duty hours that permit hospitals to assign residents longer shifts with shorter time off in between consecutive shifts. The results seemed promising: There was no drop in patient safety when residents were allowed to work longer shifts, and the perceived quality of education reported by the residents was no different. Heralding these findings, the American College of Surgeons released a statement claiming that “flexible, less restrictive policies are safe for patients, reduce handoffs, and lead to greater resident satisfaction”.
When I read the study closely, however, I had flashbacks to my earlier reservations about entering medicine. Buried in the middle of the ninth paragraph of the results section was a very telling sentence: “Flexible-policy residents were more likely to perceive negative effects of duty-hour policies on resident outcomes that depended on time away from the hospital, such as case preparation after work, research participation, time with family and friends, time for extracurricular activities, rest, and health.”
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