First-year residents in the U.S. will be able to work 24-hour shifts beginning July 1 when the 16-hour shift cap is lifted, according to a Friday release from the Accreditation Council for Graduate Medical Education.
The revision of ACGME's professional standards for accredited residencies and fellowship programs is not without controversy as the epidemic of physician burnout in the U.S. has raised concerns about both provider and patient safety in relation to overworked physicians.
Here are five things to know about the ACGME revision.
1. The new standard extends the maximum shift time of first-year residents from 16 hours to 24 hours. The standard also allows for four hours to transition patients between physicians, extending the total possible shift time to 28 hours.
2. While the new revision does extend the possible shift time for new residents, it does not extend how much time a resident can work during the week. The maximum weekly shift time remains 80 hours.
3. The revised requirements allow first-year residents to keep the same schedules as other residents and fellows. This change is spurred by a desire to improve physician education, team-based care and ultimately improve patient safety by limiting patient handoffs, according to the ACGME.
"The American public deserves to know that starting on day one physicians in practice already have the real-world experience they need to ensure high quality patient care," said Thomas J. Nasca, MD, CEO of ACGME. "Residents also have the right to develop such experience under appropriate supervision to manage the lifetime of demands and stress that come with the privilege of patient trust."
4. The 16-hour shift limit for first-year residents was established in 2011 to eliminate the 30-hour shifts some residents were working, according to The Washington Post. This limit created disharmony between physicians and hindered the educational experience of first-year residents, according to Anai Kothari, MD, a third-year general surgery resident at Loyola University Medical Center in Hines, Ill., and resident member of the ACGME task force that developed the new standards.
Dr. Kothari told the Post he missed critical moments with his patients in his first year of residency due to the cap. Dr. Kothari said the limit created "this artificial divide between upper-level and the new residents that are coming in. It really does fracture the team. That impacts patient safety certainly, but it also really affects how you're educated."
5. Public Citizen, a consumer rights advocacy group, has long opposed lengthy shifts for first-year residents. The group has categorized the new limit as a move backward for ACGME. The group contends sleep-deprived residents are more prone to experience depression, have a car accident and make medical mistakes like needle-stick errors, according to the Post.
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