Resident duty hours: the rest of the story.

This article presents the complex set of considerations and influences that resulted in the Accreditation Council on Graduate Medical Education' s (ACGME) development of rules to govern the duty hours of residents. The process is demonstrative of the complexity associated with the self-regulation of graduate medical education. At the same time, the ACGME' s development of standards for resident duty hours suggests that self-regulation can be an effective alternative to governmental regulation.