BACKGROUND: Medical residents work long, continuous hours. Working in conditions of extreme fatigue has adverse effects on the quality and safety of care, and on residents' quality of life. Many countries have attempted to regulate residents' work hours. OBJECTIVES: We aimed to review residents' work hours regulations in different countries with an emphasis on night shifts. METHODS: Standardized qualitative data on residents' working hours were collected with the assistance of experts from 14 high-income countries through a questionnaire. An international comparative analysis was performed. RESULTS: All countries reviewed limit the weekly working hours; North-American countries limit to 60-80 h, European countries limit to 48 h. In most countries, residents work 24 or 26 consecutive hours, but the number of long overnight shifts varies, ranging from two to ten. Many European countries face difficulties in complying with the weekly hour limit and allow opt-out contracts to exceed it. CONCLUSIONS: In the countries analyzed, residents still work long hours. Attempts to limit the shift length or the weekly working hours resulted in modest improvements in residents' quality of life with mixed effects on quality of care and residents' education.

• Klíčová slova
• ACGME, Cross-country analysis, EWTD, Medical residents, Nightshifts, Work hours,
• MeSH
• kurzy a stáže v nemocnici * MeSH
• kvalita života MeSH
• lidé MeSH
• personální obsazení a rozvrh * MeSH
• pracovní zátěž MeSH
• vyspělé země MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Legislation launched with the EWTD was born as a "Protection of the clinical personnel against overwork for the benefit of Patients" (consumer protection and safety). It appeared that this legislation is in direct and severe conflict with former EU legislation to train competent surgical specialists. First experiences with the EWTD show far reaching and serious consequences on the training of surgical specialists as well as on medical care. There will be a reduction of about 30-35% of clinical and operative experience acquired during the usual 6 yrs of training, with many other negative aspects (see p. 7). All measures proposed so far to overcome the ensuing problems are unworkable. The training of competent surgical specialists as required by the Directive 93/16 EEC is no longer possible and serious problems with safe patient care will occur in the short term, if no political actions are taken. The surgical specialties, represented in the UEMS, provide a proposal for a working hour model consisting of 48 hrs working time (incl. service duties) plus additional 12 hrs reserved and protected for teaching and training. This model would adhere to the EWTD on the one hand, yet maintain the desired standard of training. This proposed exemption from the EWTD would be limited to the time of specialist training. We ask the responsible politicians to find a solution rapidly to prevent serious negative consequences. This motion is supported by the surgical specialties (neurosurgery, general surgery, orthopaedic surgery, paediatric surgery, cardio-thoracic surgery, vascular surgery, oto-rhino-laryngology, list not complete) of the member states of the EU, representing more than 80,000 surgical specialists.

• MeSH
• časové faktory MeSH
• Evropská unie MeSH
• klinické kompetence MeSH
• kurzy a stáže v nemocnici zákonodárství a právo   MeSH
• kvalita zdravotní péče zákonodárství a právo   MeSH
• lidé MeSH
• obory chirurgické výchova   zákonodárství a právo   MeSH
• personální obsazení a rozvrh zákonodárství a právo   MeSH
• pracovní síly MeSH
• pracovní zátěž zákonodárství a právo   statistika a číselné údaje   MeSH
• řízení bezpečnosti zákonodárství a právo   MeSH
• společnosti lékařské MeSH
• střet zájmů MeSH
• studium lékařství specializační postgraduální zákonodárství a právo   MeSH
• vliv směnného provozu na zdraví MeSH
• vysokoškolská lékařská centra zákonodárství a právo   MeSH
• vzdělávací modely * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• úvodníky MeSH
• Geografické názvy
• Evropa MeSH