Proposed Duty Hour Limits for Residents Met with Scrutiny

Joe Cantlupe, for HealthLeaders Media , March 17, 2011

Under the latest regulations being implemented, among other things, residents must have 10 hours off between duty shifts and must have eight hours free of work between duty hours.

Residents also must not be scheduled for more than six consecutive nights of night duty; have 24 hours off per 7-day period, with maximum duty hours of 80 per week, averaged over 4 weeks, with 88 hours for selected programs. Moonlighting is not permitted.

Last September, the advocacy group Public Citizen filed a petition with the Occupational Safety and Health Administration requesting that the agency regulate resident physician and subspecialty resident physician hours.

"Depending on the type of residency, physicians-in-training can work anywhere from 60 to 100 or more hours a week, sometimes without a day off for two weeks or more," the Public Citizen petition states.

Because OSHA, which is part of the Department of Labor, is charged with ensuring the safety and health of workers, it has jurisdiction over the matter, Public Citizen and other groups that joined in the petition say.

In 2002, OSHA denied a petition by Public Citizen, the Committee of Internists and Residents (CIR), and American Medical Student Association, citing the voluntary adoption of standards by ACGME. 

Referring to its current petition, Sidney Wolfe, MD, director of Public Citizen's Health Research Group, said in a statement, "The dangerously excessive number of hours resident physicians are currently allowed to work is a similarly toxic exposure that OSHA has the authority to regulate and reduce in order to protect these physicians from harm."

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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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