LEGISLATED LIMITS FOR HOUSESTAFF TRAINING

Public concern about the impact of excessively long working hours on the provision of patient care has spurred legislation to limit the in-hospital on-call time of residents in training. However, well meaning, attempts to limit training hours must carefully evaluate the effects on patient care and trainee education as well as residents' quality of life. Initial data suggest that to focus only the limitation of working hours may not improve patient care and may create expectations that cannot be achieved until resources are provided to replace the time and effort of house officers. To achieve further changes in training programs which benefit both patients and trainees-and to do so in a reasonably cost-effective manner-will require a broader effort by trainees, educators, hospital administrators, and public officials rather than a narrow focus on arbitrarily limited working hours.