The Accreditation Council for Graduate Medical Education duty hour regulations were implemented on July 1, 2003. Pre-reform year 3 (Pre-3) included academic year 2000–2001 (July 1, 2000, to June 30, 2001); pre-reform year 2 (Pre-2), academic year 2001–2002; pre-reform year 1 (Pre-1), academic year 2002–2003; post-reform year 1 (Post-1), academic year 2003–2004; and post-reform year 2 (Post-2), academic year 2004–2005. No significant divergence was found in the degree to which mortality changed from pre-reform year 1 to either post-reform year any group. Significance levels assess whether trend from pre-reform year 1 to post-reform years 1 and 2, respectively, differed for less vs. more financially healthy hospitals.