New Rules over Medical Residents' Hours Causes Controversy

July 11, 2011

The private nonprofit Accredited Council for Graduate Medical Education has formulated a new set of rules limiting these medical interns to 16-hour shifts.

In the past it was typical for first year medical residents, also called interns, to work 28 hours at a time in hospitals with many of them working a few more hours without much rest. However, the private nonprofit Accredited Council for Graduate Medical Education has recently formulated a new set of rules limiting these medical interns to 16-hour shifts. Second and third year residents are still allowed to work 28 hours at a time but cannot take on new patients within the last four hours of their shifts.

These rules, intended to prevent medical errors due to sleep deprivation, have served to add more fuel to a debate that has stretched over many years. Those who agree with the elongated shifts believe that residents gain invaluable experience through longer hours and also learn to manage fatigue that inexorably comes with practicing medicine. The supporters of long shifts argue that patients are still getting the right care and are protected because residents are closely supervised.

In response to these points, those against longer shifts cite research showing that doctors’ performance deteriorates with long shifts because they get so tired. They argue that the residents, who make up about a quarter of physicians working in hospitals, are no different from workers in other industries, according to decades of studies linking exhaustion to accidents and errors.

In 2009, a poll of 1,200 American households published in the journal BMC Medicine found that 81 percent of respondents believed that patients should be told if their doctor has been working for over 24 hours. 80 percent stated they would then want a different doctor.

The ACGME established rules in 2003, limiting residents to 80 hours per week but allowed them to work 30 hours straight through. These new rules mark the second time the rules have been changed.

Around the Web

New Rules On Medical Residents' Hours Spur Debate [NPR]

Common Program Requirements [Accredited Council for Graduate Medical Education]

US public opinion regarding proposed limits on resident physician work hours [Proceedings from BMC Medical]