We recently published the outcomes from the iCOMPARE study in The New England Journal of Medicine. The data proved informative. First, we learned that interns—regardless of duty hour policy—spend their time in similar ways. It also confirmed what many of us feel: Our interns spend little time at the bedside (12 percent) and too much time with the electronic medical record (40 percent, or more than 10 of 24 hours). Another finding: Duty hour policies do not impact medical knowledge tested by an exam. And, perhaps not surprisingly, we found that interns and program directors experience duty hour policies differently. Interns overwhelmingly preferred standard (more restrictive) hours, while program directors overwhelmingly preferred flexible ones.

Most importantly, we learned that despite finding that most interns and residents under both policies were satisfied with their training, burnout was very high—independent of duty hour policy. 

These data shine a brighter light on the urgency to address physician burnout. They also affirm that duty hour policy is not a meaningful factor in this issue. Wellness programs, ours included, have begun to address burnout. But providing healthy snacks and massages will not be enough. We need to search for causes at the program level and well beyond.

Ultimately, iCOMPARE reminds us that the ideal learning environment is not obvious. The best structures rely on close collaboration between trainees and program directors. I'm excited about all the changes we've made to our program, built on this partnership.