Resident work hours need more regulation, advocacy groups argue

The Occupational Safety and Health Administration is considering a petition to limit residents' long work hours.
The petition, which is the latest salvo in the ongoing debate about residents hours, calls for:

• Work hours to be limited to 80 hours a week, without averaging among weeks, which under current rules allow residents to work 100 hours one week and 60 hours the next
• Any one shift to be limited to 16 hours for all resident physicians. (ACGME proposed guidelines limit these shifts for first-year residents At least one 24-hour period of off-duty time per week and one 48-hour period per month, making a total of five days off per month)
• In-hospital on-call frequency no more than once every three nights, without averaging
• At least 10 hours free between duty times 
• Nor more than four consecutive night shifts and 48 hours off after working three or four such shifts

OSHA is "very concerned about medical residents working extremely long hours," the Assistant Secretary of labor for occupational safety and health, Dr. David Michaels, said in a statement released yesterday. He also noted that they know of evidence linking sleep deprivation with an increased risk of needle sticks, puncture wounds, lacerations, medical errors and vehicle accidents. Yet studies have noted that sleepy residents don't see higher surgery complication rates than their better rested peers and that limiting hours can also impact patient safety.

The petition was submitted by Public Citizen and a coalition of groups and individuals including the Committee of Interns and Residents/SEIU Healthcare, the American Medical Student Association, and a professor of sleep medicine at Harvard Medical School.

The petitioners accused the Accreditation Council for Graduate Medical Education, the nonprofit that regulates and enforces resident physician work hours, of continuing "to abdicate its responsibility to adequately protect resident physicians," according to Medical News Today. Earlier this summer, the ACGME proposed new guidelines for resident work hours, but the groups said they still leave most residents in danger.

To learn more:
- here is the petition that groups sent to the U.S. Department of Labor
- see the OSHA statement released on Sept. 2
- here are the Accreditation Council for Graduate Medical Education's proposed standards
- read the Medical News Today article
- see the SEIU blog

Related Articles:
Wake up call: Sleepy residents don't make worse surgeons, study says
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Hourly limits for surgical residents in Switzerland negatively impact training, patient safety

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