Education board approves new rules for resident duty hours
During its annual winter meeting, the Accreditation Council for Graduate Medical Education?s board of directors approved new standards for resident duty hours.
?Residents are doing more in less time with less help. These new standards will strengthen both patient care and education,? said Dr. David C. Leach, ACGME?s executive director.
A statement released by the organization listed ACGME?s new duty hour standards: · a maximum of 80 hours per week averaged over four weeks · 10 hours off for rest and personal activities between duty periods and after call · 24 hours maximum continuous onsite duty, with up to six additional hours permitted for patient transfer · no new patients after 24 hours of continuous duty · resident time spent in the hospital during at-home call counted toward the 80 hours · program directors and faculty required to adopt policies to prevent and counteract effects of fatigue · duty hours to be monitored by the program and sponsor
The complete final standards can be found on ACGME?s Web site, www.acgme.org.
The standards are the culmination of 18 months of work by the organization to develop a standard set of duty hours for residents of all specialties. But their effect may vary from specialty to specialty.
?The new rules will have a profound affect in surgical areas, but not in radiology. If a radiology program currently has its residents working more than 80 hours, they aren?t meeting all of their other missions,? said Dr. Stephen R. Baker, associate dean for graduate medical education at New Jersey Medical School.
The provision dealing with 24 hours of continuous duty is an important one, according to Baker, because of the risks to quality created by fatigue.
?These types of programs must change. Continuous night and day shifts create medical errors and discontinuity in a resident?s educational program,? he said.
Many large radiology departments have already moved to a night flow system, according to Dr. Russell A. Blinder, residency director at Brigham and Women?s Hospital. The night flow system at the hospital is essentially a night shift program in which residents report in for work at 7 p.m. and go home around 9 a.m.
Although many radiology departments are reworking their residency hours, smaller departments may have more of a problem meeting the regulations. They do not have enough people to put into a call pool.
There may be times when residents are be on beeper call and have to perform procedures on call and then report into work the next day, but these are rare occurrences, Blinder said.
?I don?t approve of having residents reporting to work sleep-deprived,? he said.
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