# Impact of lifting work hour restrictions on first-year resident safety, health and well-being

> **NIH ALLCDC R01** · BRIGHAM AND WOMEN'S HOSPITAL · 2020 · $714,927

## Abstract

The Accreditation Council for Graduate Medical Education (ACGME) recently changed the
policy governing resident work hours in the United States, potentially impacting the safety,
health, and well-being of this occupational group. Percutaneous injuries (PI), with their attendant
risk of hepatitis, HIV, and other blood-borne illnesses, are one of the greatest occupational
hazards faced by resident physicians and motor vehicle crashes (MVC) are a leading cause of
death in their age group. In our previous work, we found that extended-duration shifts (≥ 24
hours) are associated with a 168% increase in MVCs on the commute from work in first-year
postgraduate residents (PGY1s) and a 73% increase in the risk of PI. In response to these
findings, in 2011 the ACGME implemented a 16-hour limit for PGY1 work shifts. Subsequently,
from July 2014-May 2017, we collected work hours, safety, health and well-being outcomes
from 9,596 PGY1s on 49,418 monthly web-based reports and compared these data to those
previously collected from 5,680 PGY1s (30,848 monthly reports) from 2002-2007 when PGY1s
routinely worked extended-duration shifts. Under the 2011 ACGME policy, nightly hours of sleep
increased, risk of an MVC decreased 25% and risk of PI decreased 44%. PGY1 well-being
improved, with a 25% reduction in respiratory illness and a significant increase in exercise.
Despite these improvements, the ACGME lifted these work hour restrictions in 2017. We are
uniquely positioned to immediately and directly evaluate the effect of this policy change. By
continuing to surveille PGY1 work hours, safety, health and well-being outcomes with our
nationwide survey, we will address the NORA “Healthcare and Social Assistance” sector and
the “Healthy Work Design and Well-Being Program” cross-sector. We will test the hypotheses
that the incidence rates of MVCs, near-crashes and percutaneous injuries will be increased and
resident well-being will be decreased among PGY1s working under the 2017 ACGME policy
that permits extended duration shifts. Our research will “Promote safe and healthy work design
and well-being,” one of NIOSH's seven strategic goals (specifically, 7.2A and 7.2C). We plan to
widely disseminate the knowledge gained by this research through planned outputs (in high-
impact publications). In line with the NIOSH Research to Practice initiative, we plan to engage
key stakeholders by presenting our research in national forums. As policies are changed and/or
hospitals utilize the knowledge of work design garnered from this research, we expect
improvements in the safety, health and well-being (end outcomes) of >100,000 resident
physicians, who are the principal providers of care in academic medical centers across the US.

## Key facts

- **NIH application ID:** 10026066
- **Project number:** 5R01OH011773-02
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Laura K. Barger
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2020
- **Award amount:** $714,927
- **Award type:** 5
- **Project period:** 2019-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10026066

## Citation

> US National Institutes of Health, RePORTER application 10026066, Impact of lifting work hour restrictions on first-year resident safety, health and well-being (5R01OH011773-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10026066. Licensed CC0.

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