Resident Work Conditions

The MSS has and will continue to work closely with the AMA Resident and Fellow Section (RFS) to pursue a comprehensive approach to the problem of excessive resident work hours. It is clear that for many residents and fellows, excessive work hours has a significant impact on their educational environment, the quality of care they provide to patients, and their personal well-being.

Great strides were made in July 2003 when the Accreditation Council for Graduate Medical Education (ACGME), in accord with AMA policy passed by the House of Delegates in 2002 implemented new guidelines for resident work hours, including the following:

• Duty hours are limited to 80 hours per week, averaged over a four-week period, including all in-house call activities. Duty hours include all clinical and academic activities related to residency, including patient care, administrative duties of patient care, transferring patients, in-house call activities, and scheduled academic conferences or seminars.
• Continuous, on-site duty (including in-house call) cannot exceed 24 consecutive hours. Residents may stay on duty up to 6 additional hours to transfer patients, staff outpatient clinics, or maintain continuity of care. No new patients, however, may be accepted after 24 consecutive hours.
• At-home call (pager) is not limited per se, however, it must allow for rest and reasonable personal time. When residents are paged at-home and come to the hospital, the in-house hours count toward the 80-hour limit.
• Minimum of 10 hours of rest between duty periods.
• Residents must also have 1 in 7 days free from all educational and clinical responsibilities, averaged over a 4-week period; this day must be free from all clinical, educational, administrative, and on-call activities.

Full resident work hours guidelines are available at the ACGME website.

Links for more information:

• AMA Policy Regarding Resident Work Hours
• Informational Guide (PDF, 60KB, requires Adobe Acrobat Reader)
  The MSS Legislative Awareness Committee (now called Committee on Legislation and Advocacy) put together an informational guide on this issue. This guide contains historical background on the issue of resident work conditions and descriptions of ACGME and JCAHO.