ACGME gives final nod to 80-hour workweek

A major shift in physician training is under way, but how successful the transition will be remains to be seen.

By Myrle Croasdale, AMNews staff. March 10, 2003.

July 1, 2003, will mark the dawn of a new era in physician training. On that day, all medical residents and fellows in all accredited training programs will be limited to an 80-hour workweek for the first time in the history of U.S. medical education.

The Accreditation Council for Graduate Medical Education approved new work-hour standards in June 2002 and issued a final version of the rules in February.

With just a few months left to prepare, even ardent opponents are getting on board. Success is critical, since failure is sure to bring in government intervention.

Specialties such as internal medicine, pediatrics and family practice are ahead of the curve, having put duty-hour structures into place in recent years that closely mirror the new ACGME requirements.

Surgeons, however, have been among the last to get on board, arguing that capping their residents' 100-plus-hour workweeks would undermine their educational experience. They're already being jolted by the scheduling overhauls.

"Junior faculty and junior attendings are fearing for their lives," said Jeffrey Upperman, MD, junior faculty at Children's Hospital of Pittsburgh and an associate fellow of the American College of Surgeons.

"The short-term solution is if residents can't take call, then the faculty will need to step in," he said. "If you're junior faculty with the pressure to publish or perish, that threatens your academic livelihood."

Junior surgical faculty have begun taking call at Children's, but Dr. Upperman said that's a temporary fix.