Work like a Doc: A comparison of regulations on residents' working hours in 14 high-income countries

Breuer, Rina Maoz; Waitzberg, Ruth; Breuer, Adin; Cram, Peter; Bryndová, Lucie; Williams, Gemma; Kasekamp, Kaija; Keskimäki, Ilmo; Tynkkynen, Liina-Kaisa; Ginneken, Verena van; Kovács, Eszter; Burke, Sara E.; McGlacken-Byrne, Domhnall; Norton, Carol; Whiston, Barbara; Behmane, Daiga; Grike, Ieva; Batenburg, Ronald; Albreh, Tit; Pribakovic, Rade; Bernal‐Delgado, Enrique; Estupiñan-Romero, Francisco; Angulo-Pueyo, E; Rose, Adam J.

doi:10.1016/j.healthpol.2023.104753

Cited by 3 publications

(2 citation statements)

References 59 publications

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“…The regulation of work hours for residents has been predominantly enforced in the U.S., Europe, and Canada, with other nations, particularly in Asia, more recently adopting similar measures (Table 1). 8,10,11 However, Japan is scheduled to impose such regulations in April 2024. Most countries' regulations on resident work hours consist of two components: the total number of working hours (e.g., hours worked per week) and the longest continuous working hours in a shift.…”

Section: Work-hour Reg Ul Ationsmentioning

confidence: 99%

The effects of resident work hours on well‐being, performance, and education: A review from a Japanese perspective

Nagasaki,

Kobayashi

2023

J of Gen and Family Med

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This article examines the impact of working‐hour restrictions on the well‐being, performance, and education of medical residents in Japan. Despite Japan's plan to introduce new regulations for resident working hours by 2024, there is still an ongoing debate regarding their appropriateness. This review provides a comprehensive overview of the current regulations of resident working hours worldwide, with a specific focus on weekly hours. The varying regulations are highlighted, including the 80‐hour‐per‐week regulation in the United States and the 48‐h‐per‐week regulation in the European Union influencing other regions. The article also discusses the effectiveness of working‐hour restrictions on residents' mental health, with shorter working hours having potentially greater benefits. However, the impacts on medical safety and resident education are mixed, and further reduction in working hours must be carefully considered to avoid adverse effects. The planned changes to working‐hour limits for residents in Japan offer a unique opportunity to gain new evidence on the impact of such regulations, which will be of interest to policymakers and researchers worldwide.

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Section: Work-hour Reg Ul Ationsmentioning

confidence: 99%

The effects of resident work hours on well‐being, performance, and education: A review from a Japanese perspective

Nagasaki,

Kobayashi

2023

J of Gen and Family Med

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“…Efforts to shorten work hours are also taking place in other countries [ 11 , 12 ]. While the mechanism and roadmap for reducing work hours remain a matter of debate, there is a growing consensus on its necessity.…”

Section: Reduction Of Overnight Shift Durationmentioning

confidence: 99%

Healthcare policy changes in an era of health workforce shortage

Angel

Fire

2023

Isr J Health Policy Res

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In their recent IJHPR article, Wimpfheimer and colleagues outline the implications for the field of anesthesia of two major healthcare policy changes in Israel: The Yatziv Reform in licensing foreign medical graduates and the efforts to reduce residents' on-call shift duration. We argue that these reforms are necessary to strengthen the healthcare workforce and improve the quality of care in the long term, even though they may limit the availability of healthcare personnel for several years, particularly in the field of anesthesia. In this commentary, we examine the background to these policy changes, their likely impact on the medical workforce in Israel in general, and propose steps to reconcile these reforms with the global and national shortage of physicians. We urge policymakers to allocate the required resources and begin preparing for an era of continuous mismatch between physician supply and demand, which will necessitate creative solutions, increased reliance on technology, and the introduction of paramedical professionals to help offload tasks and better utilize the scarce physician workforce.

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Working hours of full-time hospital physicians in Japan: a cross-sectional nationwide survey

Koike,

Wada,

Ohde

et al. 2024

BMC Public Health

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Background The culture of excessively long overtime work in Japan has not been recently addressed. New legislation on working hours, including a limitation on maximum overtime work for physicians, will be enforced in 2024. This study was performed to elucidate the working conditions of full-time hospital physicians and discuss various policy implications. Methods A facility survey and a physician survey regarding physicians’ working conditions were conducted in July 2022. The facility survey was sent to all hospitals in Japan, and the physician survey was sent to all physicians working at half of the hospitals. The physicians were asked to report their working hours from 11 to 17 July 2022. In addition to descriptive statistics, a multivariate logistic regression analysis on the factors that lead to long working hours was conducted. Results In total, 11,466 full-time hospital physicians were included in the analysis. Full-time hospital physicians worked 50.1 h per week. They spent 45.6 h (90.9%) at the main hospital and 4.6 h (9.1%) performing side work. They spent 43.8 h (87.5%) on clinical work and 6.3 h (12.5%) on activities outside clinical work, such as research, teaching, and other activities. Neurosurgeons worked the longest hours, followed by surgeons and emergency medicine physicians. In total, 20.4% of physicians were estimated to exceed the annual overtime limit of 960 h, and 3.9% were estimated to exceed the limit of 1860 h. A total of 13.3% and 2.0% exceeded this level only at their primary hospital, after excluding hours performing side work. Logistic regression analysis showed that male, younger age, working at a university hospital, working in clinical areas of practice with long working hours, and undergoing specialty training were associated with long working hours after controlling for other factors. Conclusions With the approaching application of overtime regulations to physicians, a certain reduction in working hours has been observed. However, many physicians still work longer hours than the designated upper limit of overtime. Work reform must be further promoted by streamlining work and task-shifting while securing the functions of university hospitals such as research, education, and supporting healthcare in communities.

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Work like a Doc: A comparison of regulations on residents' working hours in 14 high-income countries

Cited by 3 publications

References 59 publications

The effects of resident work hours on well‐being, performance, and education: A review from a Japanese perspective

The effects of resident work hours on well‐being, performance, and education: A review from a Japanese perspective

Healthcare policy changes in an era of health workforce shortage

Working hours of full-time hospital physicians in Japan: a cross-sectional nationwide survey

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