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    Medical residents angered at extended work hours

    After the Accreditation Council for Graduate Medical Education increased the hourly restrictions for interns from 16 to 28 hours, residents and physicians who have just finished their residency are upset about the change.

     

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    “Everyone I know who is working 24 or 28-hour shifts is exhausted,” says Samantha Harrington, MD, an intern at Cambridge Health Alliance in Boston. “People are lying if they say, ‘it’s great.’ The vast majority of residents and medical students I’ve talked to are disappointed and anxious. These changes point to the overall question of how we are overseeing our residents’ well-being. This is a step in the wrong direction.”

    The revised hours cap interns at a maximum of 24 hours on a shift, plus up to four extra hours to manage care transition time, according to an ACGME memo issued by Thomas J. Nasca, MD, MACP, Chief Executive Officer. In 2011, the ACGME had restricted interns’ hours to 16 per shift, and the change returns first-year residents to the same schedule as more advanced residents and fellows. 

    “The hypothesized benefits associated with the changes made to first-year resident scheduled hours in 2011 have not been realized,” Nasca says in the memo. “The disruption of team-based care and supervisory systems has had a significant negative impact on the professional education of the first-year resident, and effectiveness of care delivery of the team as a whole.”

    Jason Sood, DO, a second-year family medicine resident at several hospitals of the Rowan School of Osteopathic Medicine, says he is not surprised by the changes. “Hospitals, for their bottom line, it makes sense not having to hire physician extenders,” Sood says. “We’re cheap labor.”

     

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    Sood says he has worked two and sometimes even three 24-hour shifts in a workweek. He’s had two physician friends get into car accidents after completing 24-hour shifts, and he’s known many more who have had close calls. “And those don’t even get reported,” Sood says.

    Joel Warsh, MD, MSC, a Los Angeles pediatrician who just finished his residency last year, was really upset with the ACGME’s decision. During his residency, he had several physician friends get involved in car accidents after completing long shifts, and he had another physician friend commit suicide, in part, because of the long hours. 

    “I had one friend, who, after a 30-hour shift, was about to drive home, but fell asleep in the car and woke up six hours later,” Warsh says. “That’s scary to think that somebody would have to drive in that condition, but what are you supposed to do if you are a resident?

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