In the last decade, changes have been made to the length of duty hours for house staff at teaching hospitals. High profile media stories of exhausted interns making terrible mistakes were the primary impetus that led to these reforms. However, there were unforeseen consequences, including increased handoffs needed due to the patchwork shifts of house staff. After all the debate, the evolving literature has found outcomes have not significantly changed as a result of the duty reforms. A recent observational study found, in the first 3 years, there was no clinically important change in mortality, but after five years, there was an improvement. However, there were also many concurrent policy changes affecting safety, so it is still difficult to discern what overall effect duty restrictions have had on patient safety outcomes.

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