U.S. doctors in training to work longer hours under new guidelines

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By Andrew M. Seaman

<span class="articleLocation”>(Reuters Health) – Days may get a lot longer for some
doctors in training after the group that oversees medical
education in the United States rolled back controversial rules
limiting the number of hours first-year residents may work.

Beginning July 1, doctors in their first year of training
after medical school may once again care for patients for up to
24 hours at a time and work a total of 80 hours per week, the
Accreditation Council for Graduate Medical Education (ACGME)
announced on Friday.

In 2011, the group restricted these first-year residents to
16 hours at a stretch over concerns that patient care could
suffer if trainees were overly tired.

Opponents at the time argued the restrictions did not
protect patients and limited educational opportunities for
trainees. Their concerns were largely confirmed by a flurry of
new research.

“I think we have a little bit more information through a
review of all these studies to say we don’t think (cutting
first-year resident hours) made a major difference in patient
outcomes and experiences,” said Dr. Rowen Zetterman, who
co-chaired the ACGME task force overseeing the changes.

About one in seven active doctors in the United States is
currently in a ACGME-accredited training program, according to
the organization.

In addition to rolling back work-hour restrictions on
first-year residents, ACGME made changes to reinforce patient
safety and physician wellbeing.

At-home work will count toward a trainee’s 80-hour maximum,
for example. Trainees are also allowed to stay longer on some
cases for the benefit of patients and families.

“Once it goes into effect and residents are using it, it’ll
be viewed favorably,” said Dr. Anai Kothari, a member of the
task force and a general surgery resident at Loyola University
Medical Center in Maywood, Illinois.

The rule change is consistent with the most recent evidence,
said Dr. Michael Leitman, senior associate dean for graduate
medical education at the Icahn School of Medicine at Mount Sinai
in New York. But hospitals might not immediately change
trainees’ schedules, he said.

“Now that we’ve been at this for six years, hospitals have
learned to develop systems to deal with reduced work hours,”
Leitman said. A lot of program directors believe a period of
adjustment is good for first-year residents, he added.

ACGME will review the new changes in another five years,
said Zetterman, a professor at the University of Nebraska
Medical Center in Omaha.



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