ACGME: 24-hour shifts for first-year residents to start this summer

In 2009, the highly influential Institute of Medicine published a groundbreaking study showing how both patient safety and the safety of first-year residents, meaning those doctors in their first year of training, was severely compromised by long work shifts. Indeed, the IOM study recommended that all residents be required to work no more than 16-hour shifts.  

In response to the report and the many concerns it engendered, the Accreditation Council for Graduate Medical Education, the entity that oversees physician training, announced in 2011 that it was following the advice of the IOM and limiting first-year residents to 16-hour shifts.

As was perhaps to be expected, the move to 16-hour shifts proved divisive over the years with one sector of the medical community championing the limitation as an absolutely necessary work safety rule and another deriding it for depriving young physicians of valuable experience.

In recent developments, the ACGME announced just yesterday that it was officially reversing course and that first-year residents will be permitted to work 24-hour shifts as soon as July 1. Furthermore, it said that four additional hours will be allotted for patient transitions, such that a first-year resident could conceivably be on the clock for 28 straight hours.

As for the rationale for the move, the ACGME indicated that it will 1) help physicians gain much-needed experience by enabling them to follow their patients for longer periods, including the often critical post-admission timeframe, and 2) reduce the number of patient handoffs, which have been identified as a major source of medical errors.

The decision to move away from the 16-hour limit was swiftly condemned by a host of groups, including the health research group Public Citizen, which referred to it as a "dangerous step backwards."

It's worth noting that the ACGME left several other provisions instituted back in 2011 in place -- no more than 80 hours per week, mandatory one day off for every seven worked, no more than one overnight shift in three days, etc. -- and introduced a few new provisions as well:

  • Hospitals must provide residents with time off for physical and mental health appointments
  • Hospitals must devise measures to combat fatigue and burnout among residents  

Here's hoping this move is the right one …

If you've been seriously injured or lost a loved one due to what you believe was medical malpractice, consider speaking with a skilled legal professional to learn more about your options for pursuing justice.

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