We appreciate the thoughtful comments in these 2 letters. The discussion by Manfredini and colleagues of the European Working Time Directive's goal of a 48-hour work week offers an interesting comparative perspective. We ourselves have been particularly interested in learning from the experiences of our European colleagues1 and believe that future research should focus on the insights that can be gained from such comparison, particularly with respect to ways in which shorter work weeks might be accommodated while maintaining continuity of care and the quality of medical education.
Jagsi R, Kitch BT, Weinstein DF, Campbell EG, Hutter M, Weissman JS. Resident Hours in the Pursuit of Better Health Care—Reply. Arch Intern Med. 2006;166(13):1424-1425. doi:10.1001/archinte.166.13.1424-b