Shorter Hours for First-Year Residents

June 24, 2011
Laura Mortkowitz

Beginning July 1, first-year residents will only be able to work a maximum of 16 consecutive hours for a shift. This is down considerably from some 30-hour shifts.

New rules for first-year residents will cut the long hours of a marathon shift down to 16 hours tops. A report published by the journal of Nature and Science of Sleep pointed out the evidence linking sleep deprivation to errors in performance; facts which lead to the decision of shorter hours by the Accreditation Council for Graduate Medical Education.

The ACGME decided on the shorter hours based on a report from the Institute of Medicine and they will go into effect on July 1. However, the IOM had recommended that shorter hours go to all physicians, not just first-year residents. The more consecutive hours a resident works, the more likely his or her performance is to deteriorate.

According to the report, it was also recommended that residents aren’t even scheduled up to the maximum to allow for emergencies that might require resident physicians to stay longer than scheduled.

The shorter hours will help avoid errors. Studies have shown an increase in mistakes that injure a patient the more sleep deprived residents are. One study showed that when interns worked greater than 24 hours there was a 700% increase in mistakes injuring a patient.

Currently, the ACGME allows for shifts of 30 consecutive hours and the IOM concedes that if programs want to continue that practice, then there should be a protected five-hour sleep period occurring between 10 p.m. and 8 a.m.

The long-shifts are popular among ACGME’s constituents who believe the marathon shifts ensure competency and instill professionalism.