The effect of the New York State restrictions on resident work hours.

New York state has recently restricted the hours that residents may work to an average of 80 hours per week. We have complied with these regulations through the addition of nonresident personnel, including attending physicians, a physician assistant, and nurse midwives. This study was designed to assess the effect of these changes on our residents. A questionnaire covering the effects of our new system was distributed to both attending and resident staff. Surgical case load and Council on Resident Education in Obstetrics and Gynecology (CREOG) scores since the change were compared with those of previous years. A marked improvement in resident life-style was noted. Although residents commented that they had increased time for reading, this was not reflected in an improvement in the CREOG scores. The quality of patient care was not felt to be improved, and the continuity of care was considered to be adversely affected. Resident surgical case load was unchanged. The assignment of emergency room coverage to attending physicians and gynecologic floor coverage to a physician assistant was seen as having a detrimental effect on resident experience. We conclude that the new restrictions on resident work hours in New York have improved resident quality of life. However, there does not appear to be an improvement in patient care, which was the original intent of the statute. Concerns are discussed about the effect of this decrease in hours worked on resident experience and education. Further research is needed to assess the long-term effects of reduced resident work hours on both patient care and resident education.