ACGME Revises Cap on Resident Work Hours
by Richard Quinn • August 9, 2017
Dr. Rodney said any changes that add plasticity to the rules for residents are good changes. "Inflexibility is a bad thing in medicine, because this is not a 9-to-5 job," she added.
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Dr. Vasan added that ACGME has a challenging task to ensure that residents are learning safely. But being equal to their senior peers is a major boon to first-year residents under the revised rules.
"Interns for otolaryngology are now within our specialty for six months out of 12 months," he said. "Previously, they may have rotated through, say, one rotation of ear, nose, and throat, and the rest of the year would have been general surgery, and so on … If they're going to be involved in patient care, they should be, in my opinion, working under the same work-hour limits, restrictions, or maximums as their contemporaries."
That said, as a residency program director, he appreciates ACGME's review of the available evidence every few years to tweak work hours, ensuring the best outcomes for patients and physicians. "There's a very fine balance," Dr. Vasan added, "between getting residents maximum experience within, say, a four to five-year block versus having a period of mental and physical rest that's adequate throughout their training."
Richard Quinn is a freelance writer based in New Jersey.
History of Physician Work Hours
Thanks to television shows like "MASH" and "Scrubs," the image of exhausted physicians sleeping in any nook and cranny of a hospital they can find is a common one. But the ACGME works to make sure that's not quite true.
The long hours of medical shifts, as compared with the more traditional eight-hour workday for many, have their origin in the early days of residency, when young physicians received brief periods of intense training. Over the years, residency evolved into a multi-year process and, as early as 1981, the ACGME Common Program Requirements for Graduate Medical Education in both internal medicine and pediatrics noted the "need for time for education and personal pursuits," according to ACGME's online history of work hours.
The first formal recommendations came in 1988, when a task force said residents should spend one day in seven away from a hospital and be on call no more than every third night. The next year, the now standard 80-hour workweek, averaged over four weeks, was put in place for internal medicine. Over the next few years, five more specialties added a weekly work-hour limit.
Filed Under: Departments, Resident Focus Tagged With: career, residents, work hours