RESIDENT SERVICE HOURS IN EMERGENCY-MEDICINE

Objective: The number of hours worked by residents in all specialties has become a controversial issue. Residents often are expected to comp etently conduct patient care activities and to take educational advant age of clinical experiences in spite of frequent fatigue and sleep dep rivation. This survey of residency directors was designed to assess th e scheduled clinical time for emergency medicine (EM) residents. Metho ds: A 13-question survey dealing with time commitments of EM residents was sent to the residency directors of all accredited EM residency pr ograms in the United States in the fall of 1991, Residency directors w ere asked to indicate the number of shifts, hours, and days off per we ek; and the number of night shifts and weekend days off per month for each postgraduate year of residency training (PGY1-PGY4). Directors al so were asked whether shifts were scheduled randomly or predictably wi th progression from days to nights with time off after nights. Results : Seventy of 71 (98.6% response rate) residency directors responded. R esidents were scheduled for an average of 49.1 hours per week. Schedul ed hours decreased from an average of 51.9 at the PGY1 level to an ave rage of 44.5 at the PGY4 level, A similar progression with year of tra ining was noted for scheduled night shifts/ month, days off/week, and weekend days off/month. A PGY1 trainee averaged 7.0 night shifts/month , 1.9 days off/week, and 3.0 weekend days off/month; while a PGY4 trai nee averaged 5.3, 2.4, and 3.2, respectively. Only 40% of the director s reported predictable scheduling progressing from days to nights. Con clusion: Emergency medicine resident schedules, as reported by residen cy directors, fall well within current specialty-specific requirements and compare favorably with the reported numbers for other specialties , However, because large ranges in scheduling parameters were reported , the data may be of value to residency directors, residents, and pros pective residents, Most programs did not report a predictable schedule progression of shifts.