Resident Duty Hours: Concerns and Consequences (Editorial‪)‬

Physician educators have undoubtedly pondered optimal training paradigms for centuries. In recent years, the topic has received a great deal of attention in the United States and elsewhere. Much of the deliberation has been focused on concerns about patient safety. This emphasis is neither new nor simple. For example, the.American College of Surgeons (ACS) has emphasized patient safety since its inception in 1913, and the ACS has focused its efforts primarily on patient safety throughout the first decade of the twenty-first century. Resident fatigue has received wide attention as a potential threat to patient safety, and this issue has resonated particularly strongly with the general public and with legislators. The issue is complex. On the one hand, most of us who have survived surgical internship are well aware of the possibility that we may not perform at our best when we are excessively fatigued, and it seems reasonable to suspect that extreme fatigue may lead to impaired judgment and increased propensity toward medical errors. On the other hand, extensive, hands-on patient experience and continuity of care seem essential for optimal training, particularly in surgical specialties.