Factors affecting medical residents’ decisions to work after call (January 2024)

Summary

In the USA, Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions (WHRs) are intended to improve patient safety by reducing resident doctor fatigue. However, compliance with ACGME WHRs is not universal. This study aimed to identify factors that influence resident doctors' decisions to take a post-call day (PCD) off in line with ACGME WHRs. The authors concluded that as most important influencer of residents’ decisions to take a PCD off was related to feedback from their supervisors, compliance with WHRs can be improved by focusing on the residency program’s safety culture.

Content

Key findings

• Positive feedback from attending physicians about taking PCDs off in the past had the greatest impact on respondents’ decisions to take a PCD off, increasing the probability by 27.3%
• This was followed by chief resident comments about the resident looking tired (16.6% increase)
• There was a 13.9% increase when respondents had never heard their attendings comment about PCDs off as either positive or negative.
• Factors that had the largest effect on decreasing the probability of taking a PCD were negative feedback about taking PCDs off (14.3% decrease), continuity of care concerns (10.8% decrease), and whether the resident was looking forward to an assignment (7.9% decrease).