Educational environment changes toward resident duty hour restrictions in Japan

Abstract Japan’s workplace reforms, including a 60-hour weekly work limit for medical residents, that has been in effect from April 2024, have raised concerns about compliance and its impact on training quality. This study analyzed data from 17,967 residents who participated in the General Medicine...

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Main Authors: Kazuya Nagasaki, Yuji Nishizaki, Taro Shimizu, Yu Yamamoto, Kiyoshi Shikino, Koshi Kataoka, Hiroyuki Kobayashi, Yasuharu Tokuda
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-00347-1
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author Kazuya Nagasaki
Yuji Nishizaki
Taro Shimizu
Yu Yamamoto
Kiyoshi Shikino
Koshi Kataoka
Hiroyuki Kobayashi
Yasuharu Tokuda
author_facet Kazuya Nagasaki
Yuji Nishizaki
Taro Shimizu
Yu Yamamoto
Kiyoshi Shikino
Koshi Kataoka
Hiroyuki Kobayashi
Yasuharu Tokuda
author_sort Kazuya Nagasaki
collection DOAJ
description Abstract Japan’s workplace reforms, including a 60-hour weekly work limit for medical residents, that has been in effect from April 2024, have raised concerns about compliance and its impact on training quality. This study analyzed data from 17,967 residents who participated in the General Medicine In-Training Examination from 2019 to 2022, focusing on weekly duty hours, clinical responsibilities, and training environments. Duty hours increased from 2019 to 2021, before declining in 2022. The proportion of residents working over 60 h per week decreased from 57 to 49%, while those working under 50 h increased from 12 to 19%. Concurrently, the percentage of residents managing zero to four inpatients rose from 18 to 39%. University hospital residents reported shorter duty hours but fewer patient encounters and diminished clinical exposure compared to community hospital residents. These findings underscore the educational consequences of duty-hour restrictions, particularly in university hospitals, where reduced clinical responsibilities may compromise competency-based training. The results highlight the need for balanced policies that ensure compliance while maintaining sufficient clinical exposure. Future reforms should prioritize equitable workload distribution, increased clinical opportunities, and targeted interventions to address disparities between hospital types, thereby ensuring the dual goals of resident well-being and high-quality medical education.
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institution Kabale University
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language English
publishDate 2025-05-01
publisher Nature Portfolio
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series Scientific Reports
spelling doaj-art-c78e0ae85a814ab583d8f4e11fcc682b2025-08-20T03:53:46ZengNature PortfolioScientific Reports2045-23222025-05-0115111010.1038/s41598-025-00347-1Educational environment changes toward resident duty hour restrictions in JapanKazuya Nagasaki0Yuji Nishizaki1Taro Shimizu2Yu Yamamoto3Kiyoshi Shikino4Koshi Kataoka5Hiroyuki Kobayashi6Yasuharu Tokuda7Department of Internal Medicine, Mito Kyodo General Hospital, University of TsukubaDivision of Medical Education, Juntendo University School of MedicineDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University HospitalDivision of General Medicine, Center for Community Medicine, Jichi Medical UniversityDepartment of Community-oriented Medical Education, Chiba University Graduate School of MedicineDivision of Medical Education, Juntendo University School of MedicineDepartment of Internal Medicine, Mito Kyodo General Hospital, University of TsukubaMuribushi Okinawa for Teaching HospitalsAbstract Japan’s workplace reforms, including a 60-hour weekly work limit for medical residents, that has been in effect from April 2024, have raised concerns about compliance and its impact on training quality. This study analyzed data from 17,967 residents who participated in the General Medicine In-Training Examination from 2019 to 2022, focusing on weekly duty hours, clinical responsibilities, and training environments. Duty hours increased from 2019 to 2021, before declining in 2022. The proportion of residents working over 60 h per week decreased from 57 to 49%, while those working under 50 h increased from 12 to 19%. Concurrently, the percentage of residents managing zero to four inpatients rose from 18 to 39%. University hospital residents reported shorter duty hours but fewer patient encounters and diminished clinical exposure compared to community hospital residents. These findings underscore the educational consequences of duty-hour restrictions, particularly in university hospitals, where reduced clinical responsibilities may compromise competency-based training. The results highlight the need for balanced policies that ensure compliance while maintaining sufficient clinical exposure. Future reforms should prioritize equitable workload distribution, increased clinical opportunities, and targeted interventions to address disparities between hospital types, thereby ensuring the dual goals of resident well-being and high-quality medical education.https://doi.org/10.1038/s41598-025-00347-1Duty hour restrictionMedical residentPostgraduate medical educationWell-being
spellingShingle Kazuya Nagasaki
Yuji Nishizaki
Taro Shimizu
Yu Yamamoto
Kiyoshi Shikino
Koshi Kataoka
Hiroyuki Kobayashi
Yasuharu Tokuda
Educational environment changes toward resident duty hour restrictions in Japan
Scientific Reports
Duty hour restriction
Medical resident
Postgraduate medical education
Well-being
title Educational environment changes toward resident duty hour restrictions in Japan
title_full Educational environment changes toward resident duty hour restrictions in Japan
title_fullStr Educational environment changes toward resident duty hour restrictions in Japan
title_full_unstemmed Educational environment changes toward resident duty hour restrictions in Japan
title_short Educational environment changes toward resident duty hour restrictions in Japan
title_sort educational environment changes toward resident duty hour restrictions in japan
topic Duty hour restriction
Medical resident
Postgraduate medical education
Well-being
url https://doi.org/10.1038/s41598-025-00347-1
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