Despite opposition, medical resident work hours to increase

Chicago – Medical residents and fellows, including first-year residents, will be allowed to work for up to 28 consecutive hours without sleep as part of revised requirements recently approved by the Accreditation Council for Graduate Medical Education.

The requirements, scheduled to go into effect July 1, replace the former limit of 16 consecutive work hours for first-year residents. All other residents already were allowed to work up to 24 straight hours, plus another four hours to manage transitions in care.

ACGME said the new requirements would not change the total hours that first-year residents could work in a week. Programs must adhere to these limits, based on a four-week average:

• Residents may work up to 24 consecutive hours plus four hours for transitions in care.
• Residents may work a maximum of 80 hours in a week.
• Residents must receive one day out of seven that is free from clinical experience or education.
• Residents may be subject to in-house call no more than every third night.

The requirements include a section about promoting well-being to avoid burnout and depression.

“The American public deserves to know that starting on Day One physicians in practice already have the real-world experience they need to ensure high quality patient care,” ACGME CEO Thomas J. Nasca said in a press release. “Residents also have the right to develop such experience under appropriate supervision to manage the lifetime of demands and stress that come with the privilege of patient trust.”

ACGME’s decision drew harsh criticism from several organizations, including watchdog group Public Citizen, the American Medical Student Association and the Service Employees International Union.

“Fourth-year medical students across the country are now bracing themselves for inhuman shifts that will require them, just after graduating from medical school, to make life-or-death medical decisions and to drive home while sleep-deprived for 28 hours or longer,” Public Citizen Health Research Group Director Michael Carome said in a press release. “The ACGME’s adoption of this dangerous proposal displays a reckless disregard for the lives and health of thousands of medical residents and their patients nationwide.”