# Supervising physicians’ perceptions on physician work-hour regulations in Japan: a nationwide cross-sectional study

## TL;DR

This study explores how supervising physicians in Japan perceive new work-hour regulations, highlighting concerns about resident training and system gaps.

## Contribution

The study provides new insights into supervising physicians' perceptions of Japan's physician work-hour regulations and their potential impacts.

## Key findings

- Many supervising physicians expressed concerns about negative impacts on resident training.
- Some participants highlighted the gap between the medical field and the regulatory system.
- Organizational factors showed weak and inconsistent associations with perceptions of the regulations.

## Abstract

Japan introduced physician work-hour regulations in April 2024. Perceptions of such regulations appear to be influenced by history and culture, and thus vary among stakeholders and countries. Here, we aimed to investigate supervising physicians’ perceptions of physician work-hour regulations in Japan.

A nationwide cross-sectional study was conducted from March to April, 2024. We distributed an online anonymous self-administered questionnaire, which included closed questions about expected influence of physician work-hour regulations on various factors and an open-ended question regarding expectations or concerns about the regulations. The data were analyzed using descriptive statistics for the closed questions and inductive content analysis for the open-ended question. To explore whether various factors (sex, postgraduate years, specialty, hospital location, hospital type, and hospital size) were associated with the perceptions of the pariticpants on the implementation of physician work-hour regulations (overall, patient care, resident physician well-being, resident physician education, or supervising physician well-being), we also performed multivariable linear regression analysis.

We included 144 participants in the analysis. Many of the participants raised concerns about the negative impact of the regulations, particularly on the training of medical residents. About one-fifth of the respondents described their thoughts about the gap between the real medical field and the system. Some participants used the Japanese term jikokensan, which literally means self-improvement but is used to refer to study or research conducted by a physician with the aim of acquiring knowledge or enhancing skills apart from their primary duties, in the context of physician work-hour regulations. In multivariable analyses, several organizational factors showed statistically significant associations with supervisors’ perceptions of physician work-hour regulations. Nevertheless, effect sizes were small, there was no clear dose–dependent relationships, and findings were inconsistent across the five outcome domains; thus, no strong or consistent predictors were identified.

These results highlight the need to more fully explore supervisor perspectives, which could lead to more discourse in policy-making and an improved system of physician work-hour regulations.

The online version contains supplementary material available at 10.1186/s12909-025-08023-8.