Proposal to lengthen shifts for first-year medical residents gains support

Philadelphia – The American College of Physicians has voiced its support for a proposal that would allow first-year medical residents to work shifts of up to 28 hours without sleep.

The announcement, made Dec. 19, came about six weeks after the Accreditation Council for Graduate Medical Education proposed several revisions to its medical residency and fellowship program standards.

Since 2011, ACGME has capped shifts for first-year residents at 16 hours of consecutive time; other residents may work up to 28 hours without sleep. ACGME’s proposal would allow all residents to work up to 24 consecutive hours plus four hours to manage transitions in care.

Dr. Nitin S. Damle, ACP president, said in a statement that removing the 16-hour limit would streamline the learning process for residents.

“By mandating different hours for [first-year residents] and more senior residents, the old standard disrupted the continuity of the resident team and resulted in considerable unintended consequences without commensurate improvement in patient safety or educational outcomes,” Damle said in the statement.

Not everyone embraces the proposal. In September, watchdog group Public Citizen published results from a poll in which 86 percent of 500 respondents said they likely would feel anxious upon learning a doctor treating them had been on duty for more than 16 hours without sleeping. The same poll revealed that 77 percent of respondents believe hospital patients should be informed if a resident treating them has been working for more than 16 hours without sleep.

An ACGME task force will review comments from ACP and other groups. The task force is scheduled to send final proposed requirements to the ACGME board of directors for review in February.