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Resident work hours have been a recurring source of concern and controversy for many years. From the Spartan origins of the Halsted generic model of the surgical service at Johns Hopkins in 1897 to the present, there have been major tensions between the educational needs of learners and the workload demands of patient care, resulting, at times, in classic labor-management confrontations about work hours and conditions.

Changes in Resident Work and Sleep Hours 1999 to 2009: Results From a Survey of 4 Specialties