Fig. 10.

.Reported Non-Compliance with ACGME Work-Hour Limits as Reported by Residents Non-Confidentially to the ACGME vs. Confidentially to the Harvard Work-Hours Health and Safety (HWHS) Group. After the ACGME implemented the 2003 limits on resident physicians work hours, 83.6% of interns reported to the HWHS Group work hours that were in violation of the ACGME standards during 1 or more months. Working shifts greater than 30 consecutive hours was reported by 67.4% of interns (open bar, middle pair). Averaged over 4 weeks, 43.0% of interns reported working more than 80 hours weekly (open bar, right pair), and 43.7% reported not having 1 day in 7 off work duties (data not shown). Violations were reported during 61.5% of months during which interns worked exclusively in inpatient settings. Violations were reported to the HWHS Group from 85.4% of the 707 represented residency programs (open bar, left pair). During the same reporting period, the ACGME reported near-universal compliance with the ACGME standards (filled bars), claiming that only 5.0% of residency training programs were not compliant with the standards and that only 3.3% of surveyed residents reported violations of the 80-hour rule. Differences between the ACGME and HWHS Group data were statistically significant on each of these measures (p < 0.001). Data and legend from: Landrigan CP, Barger LK, Cade BE, Ayas NT, Czeisler CA. JAMA 2006;296:1063 (¹⁴⁸) Figure courtesy of Christopher P. Landrigan, M.D., M.P.H.