Optimal Working Hours in the 2024 Physician Work Reform: Insights from a Residency Program Director.

IF 1.7 Q2 EDUCATION, SCIENTIFIC DISCIPLINES
Advances in Medical Education and Practice Pub Date : 2025-08-20 eCollection Date: 2025-01-01 DOI:10.2147/AMEP.S540698
Kiyoshi Shikino, Yuji Nishizaki, Koshi Kataoka, Kazuya Nagasaki, Hiroyuki Kobayashi, Taro Shimizu, Yasuharu Tokuda
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引用次数: 0

Abstract

Purpose: The recently instituted Japan 2024 physician workstyle reform imposed upper limits on monthly overtime hours. However, the interpretation of these limits by different training hospitals for postgraduate medical trainees (PGY1-2) and their supervisors remains unclear. This study aimed to quantify program directors' perceptions of the "optimal" monthly overtime hours for: (1) achieving educational milestones (Q1), (2) maintaining trainees' well-being (Q2), and (3) complying with trainees' limits through supervisors' workload (Q3), and to compare urban and rural hospitals.

Patients and methods: We conducted a cross-sectional, web-based survey of all accredited postgraduate training programs (N = 644) between March 1 and April 30, 2024. Program directors responded to three single-choice questions, selecting a monthly overtime band (none, 10, 20, …100 h/month). Hospitals were classified as urban or rural based on the Ministry of Health, Labor, and Welfare criteria. Linear trends across categories were tested using the Cochran-Armitage trend test.

Results: A total of 151 directors responded (response rate: 23%). Across Q1-Q3, 40 h/month was the most frequently selected time (21-23%). However, the proportion endorsing ≥ 60 h/month was significantly higher in urban than in rural hospitals (Q1: 43% vs 23%, p = 0.0347; Q2: 34% vs 23%, p = 0.0419; Q3: 40% vs 27%, p = 0.0405). Notably, urban programs were twice as likely to consider ≥ 80 h/month appropriate for both trainees' well-being (21% vs 6%, p = 0.0066) and supervisors (21% vs 7%, p = 0.0137).

Conclusion: Although 40 h/month is the most frequent response by program directors, those from urban hospitals more commonly viewed extended hours acceptable, even exceeding the "A tier" limit of 45 h. Policy initiatives should tailor workload mitigation and task-shifting strategies to urban hospitals to safeguard the well-being of trainees and supervisors.

Abstract Image

Abstract Image

2024年医师工作改革中的最佳工作时间:来自住院医师项目主任的见解。
目的:最近制定的日本2024年医生工作方式改革规定了每月加班时间的上限。然而,不同的医学研究生培训医院(PGY1-2)及其主管对这些限制的解释仍不清楚。本研究旨在量化项目主管对每月“最佳”加班时间的看法,以实现以下目标:(1)实现教育里程碑(Q1),(2)维持受训者的福祉(Q2),以及(3)通过主管的工作量遵守受训者的限制(Q3),并比较城市和农村医院。患者和方法:我们在2024年3月1日至4月30日期间对所有认可的研究生培训项目(N = 644)进行了一项基于网络的横断面调查。项目主管回答三个单选题,选择每月加班时间(无,10,20,…100小时/月)。根据厚生劳动省的标准,将医院分为城市医院和农村医院。采用Cochran-Armitage趋势检验检验各类别的线性趋势。结果:共有151名董事参与问卷调查,回复率为23%。从第一季度到第三季度,40小时/月是最常选择的时间(21-23%)。然而,城市医院认可≥60小时/月的比例明显高于农村医院(Q1: 43% vs 23%, p = 0.0347; Q2: 34% vs 23%, p = 0.0419; Q3: 40% vs 27%, p = 0.0405)。值得注意的是,城市项目认为≥80小时/月适合受训者(21%对6%,p = 0.0066)和主管(21%对7%,p = 0.0137)的可能性是城市项目的两倍。结论:虽然40小时/月是项目主管最常见的回应,但城市医院的主管更普遍认为延长工作时间是可以接受的,甚至超过了45小时的“A级”限制。政策举措应针对城市医院制定减轻工作量和任务转移战略,以保障受训人员和主管的福祉。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Advances in Medical Education and Practice
Advances in Medical Education and Practice EDUCATION, SCIENTIFIC DISCIPLINES-
CiteScore
3.10
自引率
10.00%
发文量
189
审稿时长
16 weeks
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