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December 26, 2007

Resident Duty Hour Reform and Mortality in Hospitalized Patients

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;298(24):2865-2867. doi:10.1001/jama.298.24.2865-c

To the Editor: I was the chair of the group that recommended the original resident duty hour reform,1 the subject of 2 studies by Dr Volpp and colleagues2,3 and the accompanying editorial by Drs Meltzer and Arora.4 Although the need to change the working hours of house staff has received the most publicity, the focus of the recommendations of the committee's report was on supervision.1 Of the 17 recommendations for reform in the committee report, only 1 concerned the hours issue. The specific “80-hour week” was actually determined by a colleague on my porch and was based on the following informal reasoning: (1) there are 168 hours in a week; (2) it is reasonable for residents to work a 10-hour day for 5 days a week; (3) it is humane for people to work every fourth night; (4) subtracting the 50-hour week (10 hours per day × 5 days) from 168 hours leaves 118 hours; (5) divide 118 by 4 (every fourth night) and add to the 50 hours and, eureka, that equals an 80-hour week.

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