Institute of Medicine revises resident duty hours

The Institute of Medicine is recommending further restrictions regarding duty hours for resident physicians to reduce resident fatigue and ensure patient safety.

The current Accreditation Council for Graduate Medical Education requirements state residents must not work more than 80 hours per week averaged over four weeks, and must be provided one day in seven free from all educational and clinical responsibilities averaged over four weeks.

The IOM recommended decreasing the maximum length of shifts, increasing time off between shifts, and mandating sleep periods during long shifts. For instance, the maximum shift length would remain at 30 hours (with admitting patients or new case work restricted to 16 hours), but only if there is a five-hour protected sleep period between 10 p.m. and 8 a.m. If there is no protected sleep period, the maximum shift becomes 16 hours.

ACGME will take IOM's recommendations into account, as well as all other data. If the board adopts the findings, final changes will come into effect later this year, following a public comment period. Any changes would come into effect in July 2011 at the earliest.