Baseline duty hours recorded with time-cards: a pre-regulation study of internal medicine residents

OBJECTIVE The acquisition of data on resident duty hours has been largely dependent on self-report surveys collected in the surgical literature. We sought to implement and describe a simple method for monitoring internal medicine resident duty hours by using time-cards. DESIGN In 2002, internal medicine residents on a 3-site academic programme were asked to track their duty hours using time-cards prior to the implementation of system changes according to duty hours reform. SETTING An academic internal medicine residency programme in the USA. RESULTS Of participating residents (n = 41), 93% worked at least 1 shift longer than 30 hours, 29% worked an average of more than 80 hours per week, and 56% had less than 1 day off per week. No residents were on call more than once every third day. CONCLUSIONS This study describes the findings and challenges of using time-cards to track duty hours, and shows that many internal medicine residents on this programme were, before implementation of duty hours reforms, in violation of duty hours regulations.