The American Medical Association is endorsing a shorter workweek for medical students performing their hospital training, or residencies. The new guidelines are aimed at preventing injuries to students as well as their patients.
Many doctors in training, or residents, regularly work 100 hours per week, sometimes for 36 hours straight. It is considered both good training and a rite of passage for new doctors, but increasingly it is seen as potentially dangerous.
Earlier this month, the Accrediting Council for Graduate Medical Education, which oversees training hospitals, said medical residents will work no more than 80 hours a week beginning next year. Thursday in Chicago, the American Medical Association's policymaking House of Delegates endorsed those limits.
Peter Watson is on the AMA's Board of Trustees, and is a medical resident in Detroit. "If the AMA did not weigh in on this issue, I think it would have been a voice that would not have been heard," he said. "By speaking today, I think we are saying loud and clear that we are worried about residents and fellows who are in training, and we are worried about the potential impact of fatigue on the care of patients."
Three years ago, an Institute of Medicine report estimated mistakes in hospitals kill about 44,000 Americans each year. Doctors say there is no data suggesting how many of those mistakes are made by sleepy residents, but the AMA's Dr. Jim Rohack says there is no doubt residents are overworked, especially at hospitals with staffing shortages. "What we are seeing is a stressed situation where the resident, because of nursing shortages, because hospitals sometimes are not providing ancillary services, the resident is now being used more for service than they are for their educational component," he said.
Supporters of the longer work hours say medical residents can more quickly notice changes in a patient's condition if they are on duty around the clock. Others say residencies might have to be extended, or hospitals might have to hire more doctors if the residents' workweek is limited.