Medical resident work hours

Medical resident work hours refers to the (often lengthy) shifts worked by medical interns and residents during their medical residency.

In many locations, trainee doctors commonly work 80 to 100 hours a week, with residents occasionally logging 136 (out of 168) hours in a week. Some studies show that about 40% of this work is not direct patient care, but ancillary care, such as paperwork. Trainee doctors are often not paid on an hourly basis, but on a fixed salary; in some locations, they are paid for booked overtime.

Limits on working hours have led to misreporting, where the resident works more hours than they record.

Medical residencies usually require lengthy hours of trainees. Trainees are traditionally required to be present for set shifts, and set their own schedule outside them, working long additional hours in the hopes of improving patient care, their training, and their career prospects. The flexibility of this system makes it easy to abuse.

Junior doctors often lack bargaining power and have difficulty changing employers. This leaves them with little say over their working conditions. Critics of long residency hours note that resident physicians in the US have no alternatives to the position that they are matched to, meaning residents must accept all conditions of employment, including very long work hours, and that they must also, in many cases, contend with poor supervision. This process, they contend, reduces the competitive pressures on hospitals, resulting in low salaries and long, unsafe work hours. The Match program has also been accused of deliberately limiting the available residency posts, thus reducing the demand for residents, despite the work for much larger numbers of residents being available.

In emergencies and in chronically understaffed health systems, all staff, including junior doctors, may be overworked. In some cases, excess work may be disproportionately assigned to junior doctors.

There are financial incentives for overworking junior doctors. Since the least-experienced staff are usually paid less, it is cheaper to assign paid overtime to them. Deliberate understaffing and paid or unpaid overtime for junior doctors is thus used to reduce costs for medical facilities, although this may also reduce quality of care, which can be expensive.

The medical culture has also been blamed. "Generation-bashing", where senior doctors look down on junior doctors who work fewer residency hours than they did, can push junior doctors to overwork. A desire for formal recognition, such as promotion, may also be important. A higher "entry barrier", with work conditions poor enough to burn out some residents, may be actively desired.

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