The longing for residents across the country of a shortened work week by way of legislation is something that New York State, since 1989 at least, has had for quite some time. In New York we have what the other 49 states want: 80-hour work week with no more than 24 consecutive hours on call/on duty in a clinical setting, making decisions on patient care. Enforcement of these famous "Bell Commission" rules is an entirely different area that has only been touched upon superficially in all the rhetoric slung about by AMSA. Ask the residents of New York how many of them actually have an 80-hour week, and according to information from the AMSA website, about 60% have a workweek exceeding 95 hours and only approximately 10% actually maintain an 80-hour week. Ways certain institutions in New York State have gotten around Bell Commission regulations is by scheduling 80-hours of clinical responsibility for residents, but not taking into account the 10 or so hours of lecture residents also have to take in addition to added hours of nonclinical responsibility. Other institutions have simply told residents to lie about the number of hours they've worked when surveyors come around asking. From a purely psychological standpoint I suppose the Bell Commission rules do give residents and patients in New York State a fair amount of comfort that legislation exists to protect the two parties, but enforcement has been quite a challenge and I don't think that this pursuit of legislation is the silver bullet for the problem. Has anyone thought of ways to enforce these regulations? And if you have, could you please forward them to the NYS Department of Health? Your New York colleagues would be thankful.