Proposed Duty Hour Limits for Residents Met with Scrutiny

Joe Cantlupe, for HealthLeaders Media , March 17, 2011

The survey results, according to the researchers, "suggest that the new duty hour restrictions have the potential to create serious difficulties for residency programs to ensure that their trainees are meting the ACGME core competencies."

The new regulations include increased supervision during 16-hour shift maximum for first year postgraduate residents and recommendations for napping.

In the survey of resident medical directors, there was an outpouring of disagreement with the ACGME duty-hours regulations. Among the findings:

  • 65% say it will not change resident fatigue.
  • 6% believe it will increase fatigue.
  • 87% say that the new ACGME recommendations will decrease residents' continuity with hospitalized patients, referring to "hand-offs" during shift changes.
  • 78% say it will reduce efforts to coordinate patient care.
  • 65% believe it will reduce residents' responsiveness to patient needs.
  • 63% believe it would reduce residents' ability to effectively communicate with patients, families and other health care professionals.

Reed says it was important to question the resident medical directors about the impending regulations because "they are the ones who know what it takes to train a competent resident."

"That's why we sought their opinions," Reed says. "Some things we need to watch out for and be mindful of as the new regulations are put into place. The research isn't going to change the recommendations. That wasn't the intent. We are trying to get a sense of what program directors feel about this."

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1 comments on "Proposed Duty Hour Limits for Residents Met with Scrutiny"

Ken Murphy, MD, FACS (3/17/2011 at 10:14 PM)
This is ridiculous, as it has been since inception. The education of prospective physicians depends upon understanding how disease develops and responds to treatment over time. This can only be obtained by being available to the patients we care for precisely when they are ill. Increased supervision by attendings and upper level residents, I believe, is highly desirable; why would we not take advantage of those who have gone before? I certainly agree that fatigued residents are more prone to errors and that patient safety is our prime consideration ("first do no harm"), and I vivdly recall every-other-night call as Chief Resident in Surgery, but illness does not assume a holding pattern after business hours and on weekends/holidays. In the real world of medicine it will be critical that physicians have as-complete-as-possible knowledge of the disease processes with which they will deal. I do not recall a single time when I was "too tired" to attend a patient. I will admit that I am a dinosaur (30 yrs solo practice) but I say let's get the more experienced physicians much more involved in education of trainees, including those in private practice. Just as an aside, there is a wealth of education available in private practice, and we have yet to take adequate advantage of it in our training programs. Perhaps that is a direction which training programs should consider? Thanks. Ken Murphy, MD, FACS (Ret.) Medical Director, CRPHO UR Physician Advisor, CRMC Conway, Arkansas




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