Long Hours
Medical residencies traditionally require lengthy hours of their trainees. The American public, and the medical education establishment, is increasingly recognizing that such long hours are counter-productive, since sleep deprivation increases rates of medical errors. This was noted in a landmark study on the effects of sleep deprivation and error rate in an intensive care unit. The Accreditation Council for Graduate Medical Education (ACGME) has limited the number of work-hours to 80 hours weekly, overnight call frequency to no more than one overnight every third day, 30 hour maximum straight shift, and 10 hours off between shifts. While these limits are voluntary, adherence has been mandated for the purposes of accreditation.
Most recently, the Institute of Medicine (IOM) built upon the recommendations of the ACGME in the December 2008 report Resident Duty Hours: Enhancing Sleep, Supervision and Safety. While keeping the ACGME's recommendations of an 80-hour work week averaged over 4 weeks, the IOM report recommends that duty hours should not exceed 16 hours per shift for post graduate year 1 trainees (also known as interns). The IOM also recommended strategic napping between the hours of 10pm and 8am for shifts lasting up to 30 hours. The ACGME officially recommended strategic napping between the hours of 10pm and 8am on 30 hour shifts for residents who are post graduate year 2 and above but did not make this a requirement for program compliance. The report also suggests residents be given variable off-duty periods between shifts, based on the timing and duration of the shift, to allow residents to catch up on sleep each day and make up for chronic sleep deprivation on days off.
Critics of long residency hours trace the problem to the fact that resident physicians have no alternatives to positions that are offered, meaning residents must accept all conditions of employment, including very long work hours, and that they must also, in many cases, contend with poor supervision. This process, they contend, reduces the competitive pressures on hospitals, resulting in low salaries and long, unsafe work hours.
Read more about this topic: Medical Resident Work Hours
Famous quotes containing the words long and/or hours:
“The Tories in England had long imagined that they were enthusiastic about the monarchy, the church and beauties of the old English Constitution, until the day of danger wrung from them the confession that they are enthusiastic only about rent.”
—Karl Marx (1818–1883)
“Each morning the day lies like a fresh shirt on our bed; this incomparably fine, incomparably tightly woven tissue of pure prediction fits us perfectly. The happiness of the next twenty-four hours depends on our ability, on waking, to pick it up.”
—Walter Benjamin (1892–1940)