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Are dangerous changes to physician training standards looming?

Back in 2011, the Accreditation Council for Graduate Medical Education, the private organization that establishes training standards for physicians, made history by limiting the number of hours that first-year residents (i.e., interns) could work per shift to 16. 

These changes were hastened by the findings of a 2009 study by the Institute of Medicine, which determined after a yearlong review that doctors who worked over 16 straight hours posed a very real danger to both the patients in their care and themselves. 

Subsequent research supported this notion, as Harvard researchers found that interns who worked in the Intensive Care Unit for 24-plus hours made 36 percent more serious medical errors than their well-rested counterparts.

Furthermore, a 2007 study by UCLA researchers found that almost 20 percent of residents who worked extended shifts indicated that they had fallen asleep behind the wheel on their way home.

Given this comprehensive body of research, it came as something of a shock when the ACGME recently announced a proposal that, if adopted, would do the following:

  • Eliminate the 16-hour limit for interns and replace it with the 28-hour limit currently governing more experienced residents
  • Enable all residents to work more than 28 hours in rare instances in which they are needed
  • Eliminate the requirement that residents must not work for at least 8 hours after working shifts of less than 24 hours

Indeed, the only provision from the 2011 changes that would survive under the proposal would be the one limiting residents to workweeks of no more than 80 hours (averaged over four weeks).

While these proposed changes have been slammed by everyone from physicians to patient safety advocacy groups, supporters have argued that they will actually improve patient safety, as young physicians will not be forced to leave during critical times in the care process and be better prepared for the long shifts they'll inevitably have to work once independent.

The comment period for the proposed changes is now closed with a final vote expected in February.

Stay tuned for updates …

If you've been seriously injured or lost a loved one due to what you believe was medical negligence, consider speaking with a skilled legal professional to learn more about your options for seeking justice. 

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