Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: Department of Medicine, Massachusetts General Hospital, Boston (Dr Axelrod; firstname.lastname@example.org); and Department of Health Care Policy (Dr Jena), Harvard Medical School (Mr Shah), Boston, Massachusetts.
In Reply: Duty hour reforms in the United States and Europe have sparked vigorous debate about optimal trade-offs that must be made among the well-being of physicians in training, the continuity of care provided to patients, and the necessary experience required to prepare physicians for independent practice after completion of postgraduate medical training. Our description of the European Working Time Directive was intended to fuel further discussion and research into whether the pendulum has swung too far in Europe, where duty hour restrictions are greater than in the United States.
Axelrod L, Shah DJ, Jena AB. Duty Hour Reforms in Europe and the United States—Reply. JAMA. 2013;309(20):2094-2095. doi:10.1001/jama.2013.4096