First-Year Doctors Now Allowed to Work 24-Hour Shifts, But Is That a Good Thing?

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The Accreditation Council for Graduate Medical Education says the additional hours will enhance resident training.

First-year doctors will be allowed to work 24 hours straight starting this summer, thanks to new rules put in place by a Chicago-based group governing work standards for U.S. medical school graduates.

The Accreditation Council for Graduate Medical Education on Friday, March 10, announced its plan to oust the 16-hour work cap for first-year residents, the Associated Press reported. The move comes as part of new amendments that include restoring a longer work limit for novice doctors, which is the same maximum allowed for more advanced residents.

The 80-hour-per-week cap for doctors at all levels will remain in place, according to the news service.

Proponents of the new measures say the longer hours will help enhance training for rookies, but critics fear the potential for exhaustion and sleep deprivation put both resident doctors and patients at risk.

Dr. Samantha Harrington, a first-year resident at Cambridge Hospital just outside of Boston, said her 14-hour shifts this winter were plenty long enough. On her drives home, Harrington said she’d often have to roll down the windows and let the cold winter wind blast her in the face just to keep from falling asleep at the wheel.

The brutal hours are “based on a patriarchal hazing system,” where seasoned physicians figure, “‘I went through it, so, therefore, you have to go through it, too,'” she told AP.

Third-year resident Dr. Anai Kothari, who served on the panel that recommended the work- shift changes doesn’t see it that way, however. Kothari, who works at the Loyola University Medical Center in Chicago, said he only works long 24-hour shifts on occasion and argued that the additional hours would allow him to finish up with patients rather than leave mid-practice because he’s reached his work limit.

The latest revisions push the long-held debate over how to balance physician training with the needs and safety of patients who are sometimes left in the care of young, sleep-deprived doctors back to the forefront. Proponents assert that the changes might actually increase patient safety, as there will be fewer hand offs from doctor to doctor. The medical council also said the additional hours will allow rookie doctors to follow their patients progress for more extended periods of time.

“What we want is to be able to say at the end of residency that we have a physician who is highly trained and is ready to go out into practice,” Rowen K. Zetterman, co-chairman of a task force that spent two years examining the issue, told The Washington Post.

Zetterman said of the nation’s nearly 125,000 doctors in training, most of them end up putting in 65- to 75-hour work weeks for much of their careers.

A study on patient safety and work rules by the Institute of Medicine in 2011 prompted the accreditation council to impose the initial limit on first-year residents’ hours, axing the 30- hour-long shifts that some new doctors had been working, The Washington Post reported. Michael Carome, a physician who heads Public Citizen’s health research group, called the council’s move to lift the cap “a dangerous step backward.”

“We know from extensive research, multiple studies, that sleep-deprived residents are a danger to themselves, their patients and the public,” Carome said.

The new measures will now require hospitals and residency programs to allow residents time off for their own physical and mental health appointments, the newspaper reported. Medical institutions must also provide young residents with a means to combat burnout and fatigue.

 

 

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