Press Release (June 20, 2002)

Policy is the first time nation’s largest physician organization has set limits on work for new doctors

June 20, 2002

CHICAGO – The American Medical Association House of Delegates approved a wide-ranging new policy today regarding the working conditions for resident physicians, including imposing limits on the number of hours they can work. This is the first time the AMA has adopted policies with specific definitions, hours and working conditions for resident physicians.

"The AMA House of Delegates took a bold step in approving this new policy," said AMA Resident Trustee Peter Watson, MD. "Resident work hours and conditions have been a high-priority issue for the AMA’s Resident and Fellow Section and Medical Student Section for many years. Instituting these rules will greatly enhance medical education across the nation and, in turn, produce the highest quality new physicians."

The policy was presented in a report by the AMA’s Council on Medical Education that was submitted to the full AMA House. Some of the highlights include:

• Limits total residency duty hours to 80 per week, averaged over a two-week period. The AMA will work with graduate medical education accrediting bodies to determine if an increase of 5 percent may be appropriate for some training programs;
• Restricts scheduled on-call assignments to 24 hours, with up to six additional hours to complete transfer of care, patient follow-up and education;
• Limits scheduled on-call shifts to no more than every third night and requires one day off in seven;
• Requires that any limits on total duty hours must not adversely affect resident physician participation in the organized educational activities of the residency program.  

The guidelines also encourage the Accreditation Council for Graduate Medical Education (ACGME) to vigorously enforce accreditation standards approved by the ACGME Board of Directors on June 11 regarding resident work hours. The AMA House asked for a report from ACGME on some of its review activities with regard to the new standards. ACGME accredits nearly 7,800 residency education programs in the United States.

AMA officials stressed that they will actively monitor ACGME’s enforcement of its new standards. The AMA hopes these rules will avoid premature legislative action on this subject.

The AMA’s guidelines were brought about by a genuine concern on the part of the members of the Resident and Fellow Section and the Medical Student Section regarding the working and learning environment for resident physicians.

The formulation of the recommendations was based in part on the findings presented last October at a conference co-sponsored by the AMA on Sleep, Fatigue and Medical Training.

"The AMA is deeply concerned with patient safety and the welfare of our physicians in training," Dr. Watson said. "These new standards will go a long way toward ensuring that these concerns are addressed."