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Petition asks OSHA to limit resident work hours

The AMA seeks voluntary compliance with standards created by the Accreditation Council for Graduate Medical Education rather than government intervention.

By Jay Greene, amednews staff. May 21, 2001.

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Medical education experts agree that residency training should balance work with education to produce competent and caring physicians. But as teaching hospitals cut support staff and treat sicker patients requiring more care, residents often find that balance shifting toward the work end of the equation.

For the last 10 years the medical community has debated how to ensure that residents aren't working so many hours that their ability to provide quality care is diminished. The Accreditation Council for Graduate Medical Education, the body that accredits the nation's 7,600 residency programs, has taken steps within some specialties to discourage long work hours and ensure residents have sufficient rest and educational time.

But more than 10% of residency programs surveyed in 1999 -- or 243 of 2,078 in 27 specialties -- violated work hour compliance standards, most of which have been in place less than 10 years, said ACGME. Citations for duty hour standards have been increasing over the last three years, ACGME said. However, the council's only penalty for noncompliance is removal of accreditation -- a punishment it has yet to wield.

Given the number of violations and the lack of enforcement tools, it's not surprising that some medical students and residents are now calling for federal regulation of work hours.

In a petition filed last month with the Occupational Safety and Health Administration, three consumer and physician advocacy groups decided to seek federal regulations that would limit work hours for residents and fellows. The six-point guidelines include limiting hours to an average of 80 per week. The petition states that some residents work between 60 and 135 hours a week. [...]