Doctors in training at teaching hospitals would continue to be limited to an 80-hour workweek, but some new limits would be imposed to cut down on errors by sleep-deprived residents under new standards approved on Tuesday by the Accreditation Council for Graduate Medical Education.
The standards, which are scheduled to take effect in July 2011, will apply to the 111,000 medical residents who are training in accredited teaching institutions,
Residents can work more than 80 hours some weeks, as long as the average over a four-week period doesn’t exceed 80. First-year residents would be limited to working no more than 16 hours a day—down from 24 hours—and they would be supervised more closely. Residency-training programs would also have a tougher time getting exceptions to the work-hour limits.
The changes are based on recommendations made in 2008 by the Institute of Medicine, which warned of widespread medical errors caused by sleepy residents, as well as a 16-month review of scientific writings on sleep issues, patient safety, and resident training.
Some teaching hospitals have argued that limiting residents’ work hours would hurt them financially without necessarily improving patient safety.
The revised standards, which also deal with concerns about mistakes that occur when residents hand off patient-care responsibilities during shift changes, were developed by a 16-member task force made up of specialists from medical education, patient safety, and clinical care.
