Duty Hour Reform and Internal Medicine Residency Training: No Time to Lose
In the six years since restrictions were placed on resident work hours, much discussion and debate have ensued regarding the impact of these limitations on resident education and patient care. In 2008, the Institute of Medicine released a report encouraging further limits on resident work hours including a maximum shift of 16 hours unless five hours of protected sleep was provided.1 In response to this, the Accreditation Council for Graduate Medical Education (ACGME) is currently reviewing resident duty hours with a pledge to “completely examine resident duty hour standards, with a goal of making them better.”2 Although further duty hour limits for residents seem likely, there is no consensus on the impact of the initial regulations on patient care and education. In light of this, we believe internal medicine residency educators must actively participate in these discussions and serve as advocates for patients and residents through innovation and research.
In this issue of JGIM, Volpp a
- Institute of Medicine. Optimizing graduate medical trainee (resident) hours and work schedules to improve patient safety. 2007.
- Open Letter to GME Community from Thomas Nasca, MD, MACP, ACGME CEO. Available at: http://www.acgme.org/acWebsite/home/nascaletter_feb2009.pdf. Accessed on August 2, 2009.
- Volpp KG, Rosen AK, Rosenbaum PR, et al. Did duty hour reform lead to better outcomes among the highest risk patients? J Gen Intern Med. 2009. doi:10.1007/s11606-009-1011-z
- Volpp KG, Rosen AK, Rosenbaum PR, et al. Mortality among hospitalized Medicare beneficiaries in the first two years following ACGME resident duty hour reform. JAMA. 2007;298:975–83. CrossRef
- Volpp KG, Rosen AK, Rosenbaum PR, et al. Mortality among patients in VA hospitals in the first two years following ACGME resident duty hour reform. JAMA. 2007;298:984–92. CrossRef
- Rosen AK, Loveland SA, Romano PS, et al. Effects of resident duty hour reform on patient safety among hospitalized Veterans Health Adminstration and Medicare patients. Med Care. 2009;47:723–31. CrossRef
- Blanchard MS, Meltzer D, Polonsky KS. To nap or not to nap? Residents’ work hours revisited. NEJM. 2009;360:2242–4. CrossRef
- Landrigan CP, Barger LK, Cade BE, Ayas NT, Czeisler CA. Interns’ compliance with accreditation council for graduate medical education work-hour limits. JAMA. 2006;296(9):1063–70. CrossRef
- Arora VM, Georgitis E, Woodruff JN, Humphrey HJ, Meltzer D. Improving sleep hygiene of medical interns: can the sleep, alertness, and fatigue education in residency program help? Arch Intern Med. 2007;167(16):1738–44. CrossRef
- Bell BM. Supervision, not regulation of hours, is the key to improving the quality of patient care. JAMA. 1993;269:403–4. CrossRef
- Weinger MB. Vigilance, boredom, and sleepiness. J Clin Monit Comput. 1999;15:549–52. CrossRef
- Duty Hour Reform and Internal Medicine Residency Training: No Time to Lose
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Journal of General Internal Medicine
Volume 24, Issue 10 , pp 1169-1170
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine, Northwestern University Feinberg School of Medicine, 251 E. Huron St., Galter 3-150, Chicago, IL, 60611, USA
- 2. Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, IL, 60611, USA