US doctors-in-training to go back to longer hours

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The Accreditation Council for Graduate Medical Education has rolled back controversial rules limiting the number of hours US first-year residents may work.

Reuters Health reports that the Accreditation Council for Graduate Medical Education (ACGME) has announced beginning 1 July, 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.

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 US is currently in a ACGME-accredited training programme, according to the organisation.

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 favourably,” said Dr Anai Kothari, a member of the task force and a general surgery resident at Loyola University Medical Centre in Maywood, Illinois.

The report quotes Dr Michael Leitman, senior associate dean for graduate medical education at the Icahn School of Medicine at Mount Sinai in New York as saying that the rule change is consistent with the most recent evidence. 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 programme 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 Centre in Omaha.

Reuters Health report

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