Is Your Resident Sleepy? … Not Anymore 5/31/2011

What is a Resident? “Any physician in an accredited graduate medical education program, including interns, residents, and fellows.” -ACGME Glossary of Terms www.acgme.org

Why Residents? Chances are when you go to a hospital you would first be seen by a resident before an unsupervised doctor looked at your case. However, historically residents are assigned the worst hours and the longest hours.

In fact in the past the hours that truck drivers used to be more regulated than those of residents.

Terms to Know In-house call - duty hours outside normal work day when residents are required to be immediately available Duty hours – all clinical and academic activities related to program Night-float – assigned duty hours during night hours designed to assist or eliminate in-house call PGY-1 –post graduate year 1 All other definitions can be found at www.acgme.org

Duty Hour Standards as of 2003 A resident … Is to work no more than 80 hours per week, including moonlighting Is to have one day off a week Is to have a ten hour rest period between duty periods and in-house call In-house call is only to be scheduled once every three nights On-site duty, including in-house call, is not to exceed 24 consecutive hours Residents remaining on duty to maintain continuity of medical care or participate in outpatient clinics, etc., may only do so for six additional hours after the 24 hour limit -ACGME, www.acgme.org

Duty Hour Standards Effective July 1, 2011 A resident … Is to work not more than 80 hours per week, including moonlighting Is to have one day off a week with no in-house call scheduled Is to work not more than 24 consecutive duty hours PGY-1 is to work no more than 16 consecutive duty hours Is to have at least 14 hours of rest between 24 hour on duty periods PGY-1 is to have a minimum of eight hours between duty periods; it is recommended to have ten Is not to be scheduled for in-house call more frequently than every third night Is not to be scheduled for more than six consecutive nights of in-house night float

Just Some Statistics The cost of these new regulations could be anywhere from 1.6 to 2.5 billion dollars Even at this cost, the ACGME (American Council for Graduate Medical Education) changed the standards to serve the patients better and to serve the residents better. After all … a doctor’s first duty is to due no harm.

Sources American Council for Graduate Education. May 31, 2011. www.acgme.org. American Medical Association. May 31, 2011. www.ama-assn.org