In Reply: Duty hour reforms in the United States and Europe have sparked vigorous debate about optimal tradeoffs that must be made among the well-being of physicians in training, the continuity of care provided to patients, and the necessary experience required to prepare physicians for independent practice after completion of postgraduate medical training. Our description of the European Working Time Directive was intended to fuel further discussion and research into whether the pendulum has swung too far in Europe, where duty hour restrictions are greater than in the United States.
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