The 80-hour workweek

The 80-hour workweek developed over the past 2 decades in medical education. Under increasing pressures from government, governing bodies, and the public, residency directors must train residents, maintain standards, and still comply with the new guidelines of the Accreditation Council for Graduate Medical Education (ACGME). Surgical residency programs had weekly hours averaging 100 to 120. Trying to decrease hours in the face of nationwide hospital budget reductions is a monumental task. To understand this challenge and its implications, surgical residency training, from Halsted to the death of Libby Zion and resulting work hour reforms in New York, are reviewed. Reactions to the reforms and further changes, including recently proposed legislation, are also discussed, as are the effects on residency training and future implications.