The ACGME (American College of Graduate Medical Education) last updated its rules for resident work hours in 2003, when it released guidelines that said medical residents couldn't work shifts longer than 30 hours and no more than 80 hours a week on average in a month. The rules also mandated residents must have one day in seven free from all clinical responsibilities on average over a month. At the time this was a huge change prompting an uproar in the medical community and endless "when I was a resident" stories from our superiors, but rules were put into place for the safety of both patients and physicians. The changes took place just prior to me starting my intern year.
Now new changes are going into effect in 2011. The changes which apply only to interns (first year residents). They require an 80-hour limit on the work week and a 16-hour shift maximum for first-year residents, with a mandate for inhouse supervision at all times. No intern will ever experience a 30+ hour shift again. They won't know how it feels when your legs throb and swell from being on your feet for a day and a half straight. They won't feel the delerium set in around hour 27. They won't learn that if you dont carry a water bottle with you all night instead of caffeine your lips will be chapped for a week. I never thought I would be in a position so soon to say "when I was an intern/resident," but what a difference 6 years can make.
Residents (year 2 and above) hours are changing too. They will have a maximum of 24 hours of continuous duty (instead of 30) and are encouraged to take " strategic napping, especially after 16 hours of continuous duty and between the hours of 10 p.m. and 8 a.m., is strongly suggested.” They may take call no more than every third night.
I'm not saying this is a bad change. Studies have shown health problems related to chronic sleep deprivation as well as work place accidents. It's hard to imagine become the physician I am without going through residency the way I did, but I suppose that is what the older generation of physicians said about me when the 80 hour work week went into effect in 2003. There will be lots of obstacles to overcome with the new duty hour rules. Time will tell.
1 comment:
I never understood how it was in any way a good thing to put extremely sleep deprived people in a position to make life or death decisions for other people. You would never fly on an airplane where the pilot was at the tail end of a 30 hour shift. I can't see how the new rules can be anything but good for the public at large. If doctors want to haze each other can't they find a way to do it that's less risky to other people? Just a thought...
Plus, I'm lazy.
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