Faculty need to accept limitations on the roles residents will play under new duty hours. This means that when residents leave "on time," their departures should not be interpreted as a sign of laziness or disinterest. The "culture" of medicine often equates the number of hours on the job and without sleep with professionalism and dedication to patient care.1 Leaving on time, rather, should be viewed as healthy behavior and a sign of resident commitment to excellence in patient care and dedication to patient well-being and -- faculty are instrumental in supporting this new culture for both the resident and patient well-being.
Residents will likely be better rested under the new work hours, but they will still experience periods of chronic sleep deprivation, getting less sleep than is physiologically required. Remember that even though the numbers of hours worked have been reduced, residents are still working:
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twice as many hours as most U.S. adults
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longer than people in other stringently regulated high-risk occupations, such as commercial airline pilots.
For these reasons, strict compliance with the ACGME duty hours is a necessary, but not a sufficient strategy to prevent fatigue. Therefore, it is important for faculty to educate residents on implementing strategies to manage fatigue.
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