Adequate working hours and skill earning.

Abstract

Long working hours have caused many pediatricians to burn out and become depressed, and, as a result, many human errors have occurred, not only in outpatient clinics but also in inpatient wards. This phenomenon has also been observed in the neonatal intensive care unit, obstetrics and gynecology, and in surgical subspecialties. To prevent these human errors, the US Accreditation Council for Graduate Medical Education (ACGME) has set a cap of 80 h/week, and also a mandate on the amount of sleep/personal time for residents (10 h between shifts), as well as the maximum length of shifts (16 h with 30 h maximums), and the number of overnight calls (no more than once every 3 days). The European Union working time directive has also set 48 h as the maximum limit. These restrictions, however, generated criticisms with regard to the resulting lower volume of experience and slower acquirement of higher skills. After two resident deaths by suicide in New York City in 2014 within 1 week of each other, the ACGME called to national leaders and ran symposia on physician wellbeing in November 2015 and 2016. As a result, the American Pediatric Society National Conference ran a session named Peds21 – Pediatricians Leading Change in Physician Health and Wellness, in Chicago, September 2017, to address the relationship between burnout, job satisfaction, quality care and patient safety, and also to teach self-resilience. In the meantime, the Japan Pediatric Society has also strived to reduce pediatrician working hours by concentrating the workforce and inpatient beds into bigger regional pediatric centers, not only to prevent pediatrician exhaustion and suicide, but also to improve teamwork and achieve better patient outcomes. To ensure this, higher volumes of experience and skill earning in adequate working hours are crucial in clinical settings worldwide. The author declares no conflict of interest.