- The Accreditation Council for Graduate Medical Education, the organization that oversees physician training in the U.S., wants to lift the 16-hour shift limit for first-year residents, saying it would improve continuity of care and align interns with second- and third-year doctors.
- Under revised rules, proposed last week, first-year trainees could work up to 28 hours straight without sleep while caring for patients — up from 16 hours currently.
- The recommendation comes amid pressure from physician groups, who contend the limit has undermined patient care by increasing the number of patient handoffs between doctors.
ACGME imposed the 16-hour limit for new trainees in 2011, following a 2009 Institute of Medicine report that found residents working 24-hour shifts were more likely to harm themselves and their patients, and at higher risk for automobile accidents.
While increasing shift lengths, the proposed rules would not extend the maximum hours a resident can work per week. That would remain at 80 hours, averaged over four weeks. According to ACGME, it took steps to ensure the well-being of residents. For example, residents would be limited to one overnight shift every three days and would be guaranteed one day off per week. But the group also said that residents need to train in a real-world medical setting, which typically involves 24-hour shifts.
The advocacy group Public Citizen called the plan a “dangerous step backward.”
“Study after study shows that sleep-deprived resident physicians are a danger to themselves, their patients and the public,” Michael Carome , director of Public Citizen’s Health Research Group, said in a release. “It’s disheartening to see the ACGME cave to pressure from organized medicine and let their misguided wishes trump public health.”
The American Medical Students Association has also criticized the plan, arguing that what is needed is better communication during patient handoffs, not longer work shift, The Washington Post reports.
Teaching hospitals would not have to institute 24-hour shifts for interns. In a letter to medical educators, ACGME CEO Tomas Nasca said programs could continue to configure their clinical schedules in 16-hour shifts if they preferred, according to Forbes.
The group is accepting comments on the proposed rules through Dec. 18.