Teaching Hospitals Face New Round of Duty Hour Restrictions on Residents

A new set of proposed accreditation standards would further limit duty hours of residents working in teaching hospitals, according to a release by the Accreditation Council for Graduate Medical Education.

The ACGME, which initially limited residents' duty hours in 2003, now proposes to limit first-year residents to 16 consecutive work hours. Other residents would still be allowed to work for 24 consecutive hours, but they could not see new patients after 16 hours.

The Wall Street Journal
said the proposed rules "would likely pose logistical and financial challenges for teaching hospitals." The detailed proposed rules include new expectations on direct supervision of younger residents, handovers of patients and use of alertness management and fatigue mitigation strategies.

A variety of studies have linked residents' fatigue to medical errors, such as a 2004 study finding first-year residents on all-night shifts every third night were involved in more than half of preventable adverse events in the hospital.

The standards, scheduled to go into effect in July 2011, are available for comment on the ACGME website until Aug. 9.

The 400 major teaching hospitals where most residents work provide 22 percent of services to Medicare beneficiaries, 28 percent of all Medicaid care and 41 percent of hospital-based charity care.

Read the ACGME press release on residents.

Read the Wall Street Journal report on resident duty hours.


View and comment on the entire proposed standards.

Read other articles on residents and teaching hospitals.

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