Should first-year MDs go back to 24-hour shifts?

Published on Mar 13, 2017 at 9:12 pm in Medical Malpractice.

If you were to ask your longtime physician about their time as a resident, they would more than likely look back with some ambivalence, perhaps describing a 12-month period highlighted by significant learning, but also very long shifts and sleepless nights.

While the life of the first-year doctor-in-training was indeed long characterized by 24-plus hour shifts, this changed back in 2011 when the Accreditation Council for Graduate Medical Education, citing concerns about both patient and physician safety, changed the maximum number of hours a resident could work to 16.

Interestingly enough, the ACGME, which establishes work rules for medical school graduates here in the U.S., recently announcedthat it this shift limit would be extended to 24 hours starting July 1.

Why exactly is the ACGME doing this?

According to the ACGME, the initial hope in instituting the 16-hour limit was that it would improve patient care, something that it says has not happened over the last five years. Indeed, it indicates that its research found that the opposite actually happened with shorter shifts, such that fewer hours resulted in more patient disruptions.

Officials believe that a return to 24-hour shifts will serve to reduce this disruption, as well as the accompanying confusion and the prevalence of medical mistakes that can result from too many patient transfers. They also point to surveys showing that many young physicians prefer this structure, as it facilitates their learning.

What about the 80-hour per week rule?

Back in 2011, the ACGME introduced another rule stating that residents could work no more than 80 hours in a given week. This rule was not affected by the recent announcement.

Do residents have to work 24-hour shifts?

There is no requirement for residents to work 24-hour shifts. The change merely means that residents may work this long or be asked to work this long.

Is the medical community supportive of this shift?

The response to the ACGME’s action has been mixed with some groups arguing that it will provide residents with the opportunity to learn more and be there for patients, while others are arguing that it’s a retrograde policy at best.

Here’s hoping that the move back to 24-hour shifts is the right one.

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