Kazuya Nagasaki1, Yuji Nishizaki2, Tomohiro Shinozaki3, Hiroyuki Kobayashi1, Taro Shimizu4, Tomoya Okubo5, Yu Yamamoto6, Ryota Konishi7, Yasuharu Tokuda8. 1. Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan. 2. Division Medical Education, Juntendo University School of Medicine, Tokyo, Japan. 3. Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan. 4. Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan. 5. Research Division, National Center for University Entrance Examinations, Tokyo, Japan. 6. Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Tochigi, Japan. 7. Education Adviser Japan Organization of Occupational Health and Safety, Kanagawa, Japan. 8. Muribushi Okinawa for Teaching Hospitals, Okinawa, Japan.
Abstract
PURPOSE: The relationship between duty hours (DH) and the performance of postgraduate residents is needed to establish appropriate DH limits. This study explores their relationship using the General Medicine In-training Examination (GM-ITE). MATERIALS AND METHODS: In this cross-sectional study, GM-ITE examinees of 2019 had participated. We analyzed data from the examination and questionnaire, including DH per week (eight categories). We examined the association between DH and GM-ITE score, using random-intercept linear models with and without adjustments. RESULTS: Five thousand five hundred and ninety-three participants (50.7% PGY-1, 31.6% female, 10.0% university hospitals) were included. Mean GM-ITE scores were lower among residents in Category 2 (45-50 h; mean score difference, -1.05; p < 0.001) and Category 4 (55-60 h; -0.63; p = 0.008) compared with residents in Category 5 (60-65 h; Reference). PGY-2 residents in Categories 2-4 had lower GM-ITE scores compared to those in Category 5. University residents in Category 1 and Category 5 showed a large mean difference (-3.43; p = 0.01). CONCLUSIONS: DH <60-65 h per week was independently associated with lower resident performance, but more DH did not improve performance. DH of 60-65 h per week may be the optimal balance for a resident's education and well-being.
PURPOSE: The relationship between duty hours (DH) and the performance of postgraduate residents is needed to establish appropriate DH limits. This study explores their relationship using the General Medicine In-training Examination (GM-ITE). MATERIALS AND METHODS: In this cross-sectional study, GM-ITE examinees of 2019 had participated. We analyzed data from the examination and questionnaire, including DH per week (eight categories). We examined the association between DH and GM-ITE score, using random-intercept linear models with and without adjustments. RESULTS: Five thousand five hundred and ninety-three participants (50.7% PGY-1, 31.6% female, 10.0% university hospitals) were included. Mean GM-ITE scores were lower among residents in Category 2 (45-50 h; mean score difference, -1.05; p < 0.001) and Category 4 (55-60 h; -0.63; p = 0.008) compared with residents in Category 5 (60-65 h; Reference). PGY-2 residents in Categories 2-4 had lower GM-ITE scores compared to those in Category 5. University residents in Category 1 and Category 5 showed a large mean difference (-3.43; p = 0.01). CONCLUSIONS: DH <60-65 h per week was independently associated with lower resident performance, but more DH did not improve performance. DH of 60-65 h per week may be the optimal balance for a resident's education and well-being.
Entities:
Keywords:
General medicine in-training examination; in-training examination; postgraduate medical education; resident duty hours; resident well-being