Duty Hour Regulations of Physicians in Training and Circadian Considerations

  • Eric J. OlsonEmail author


Residency and fellowship training of physicians are marked by long hours, night call, and shift work. While this prepares trainees for independent practice, it also produces sleep deprivation and circadian disruptions that may imperil personal wellbeing, professional development, and patient safety. Accordingly, duty schedules have been increasingly controlled, yet not without controversy due to varying effects on trainee wellness, education, and patient care. Regulation of house staff work conditions has primarily focused on limiting work hours and less on mitigating occupational circadian disturbances. This chapter reviews the interaction of trainee work schedules on sleep and circadian physiology, the personal and professional effects of sleep/circadian disruptions on trainees, the evolution of the duty hour regulations in the United States, and the mixed impacts of those policies on healthcare providers and their patients.


Accreditation Council for Graduate Medical Education (ACGME) Fellow Institute of Medicine Harvard Work Hours Health and Safety Group Intern Night float Resident 


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Copyright information

© The Author(s) 2020

Authors and Affiliations

  1. 1.Department of Medicine, Division of Pulmonary and Critical Care Medicine, and Center for Sleep Medicine, Mayo ClinicRochesterUSA

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