Proposed rule would let residents work up to 28 hours in a row

Medical residents may be able to work up to 28 hours consecutively under new standards proposed by the Accreditation Council for Graduate Medical Education (ACGME). The new rule would allow residents to work up to 24 hours, plus an extra four to manage care transitions. Currently, first-year residents can work no more than 16 hours at a stretch.

According to the ACGME, the AOA’s residency hour limit policies influenced their decisions. The AOA submitted testimony to the ACGME on the proposed standards, noting its support for:

• 80-hour work weeks residents, averaged over four weeks.
• Limiting first-year residents to 24-hour shifts plus one additional hour for continuity activities.
• For residents who’ve completed their first year, a limit of 24 hours of work with up to six hours for continuity activities.
• Differing duty hour requirements for procedural-based specialties.

Proponents of the proposed rule say it would provide more realistic medical training and would make patient care safer by reducing the number of times a patient must be “handed off” to a different clinician. Opponents of the proposal, however, say overtired residents could pose a risk to patient safety.

“Just as drivers learn to drive under supervision in real life on the road, residents must prepare in real patient-care settings for the situations they will encounter after graduation,” ACGME CEO Thomas Nasca, MD, said in a statement. “Residents must develop the skills and the confidence to manage challenging situations, under supervision, and must learn to care for patients over extended hours, and during night-time hours, because these are circumstances they will encounter after graduation.”

The proposed rule is open for public comment until Dec. 19, 2016. To learn more, read the ACGME news release or NPR’s coverage of the proposed change.