The Mediating Role of Working Hours in the Effect of Surgical and Internal Medicine Residents’ Fear of Malpractice on Defensive Medical Practices

BACKGROUND: The fear of malpractice is a significant factor influencing physicians' decision-making processes in modern medical practice. This can cause defensive medicine, which involves behaviors such as requesting unnecessary tests and imaging, avoiding high-risk patients, and applying cautious but sometimes medically unnecessary treatments. The aim of this study is to evaluate the effect of surgical and internal medicine residents' fear of malpractice on defensive medicine attitudes, while examining the mediating role of working hours on this relationship. METHODS: This study is a cross-sectional investigation designed to examine the impact of surgical and internal medicine residents' fear of malpractice on defensive medical practices. The Fear of Malpractice Scale and the Defensive Medical Practices Attitude Scales were used to collect data. Years of residency, working hours, and opinions on the subject were also included during data collection. RESULTS: The findings revealed a statistically significant and strong positive correlation between fear of malpractice and defensive medical practices. The total score on the Malpractice Fear Scale showed a strong positive correlation with the total score on the Defensive Medicine Practices Attitude Scale. However, work variables such as average weekly working hours and length of residency do not play a mediating role in the relationship between fear of malpractice and defensive medical practices. CONCLUSION: This study supports the notion that fear of malpractice is a central factor influencing physicians' decision-making processes and increases positive defensive behaviors, such as requesting unnecessary tests, and negative defensive behaviors, such as avoiding high-risk patients. Cite this article as: Kasali K, Kahramanlar AA, Yılmaz MA, .zg.dek HB, Şenocak E. The mediating role of working hours in the effect of surgical and internal medicine residents' fear of malpractice on defensive medical practices. Eurasian J Med. 2026, 58(1), 1279, doi:10.5152/eurasianjmed.2026.251279.