A work in progress: Reshaping residency

Cutting residents' hours triggered a string of changes that the ACGME hopes will benefit, not hurt, the medical profession in the long haul.

By Myrle Croasdale, AMNews staff. March 13, 2006.

Physicians agree that curtailing residents' work hours has had a tremendous impact on the medical profession, but whether it's been for good or bad is still up for grabs.

The controversial decision to limit residents to an average of 80 hours a week, 30 hours straight of in-hospital call and call frequency no more than every third night had many concerned that residents' training would suffer because they would miss out on the continuity of caring for a patient from beginning to end. There also was fear that hospitals would be short-staffed and that others in the system would be left to cope with the work overflow.

So far, studies have shown that, to some degree, all of these things have occurred. But there's also evidence that some programs are developing ways to protect residents' hours and learning experiences.

Those who support the new rules say the effort will make physician training better and patients safer in the long run, including David C. Leach, MD. He is executive director of the Accreditation Council for Graduate Medical Education, the institution that put these rules in place July 1, 2003. AMNews reporter Myrle Croasdale recently talked to Dr. Leach about the changes.

AMNews: A number of studies have come out since the work-hour rules were put into place. A recent one found that medical students were spending more time doing administrative tasks and less time learning. Another found that faculty were picking up more of residents' patient care duties at the expense of career-advancing research. Are the duty-hour limits shortchanging those who don't have hour restrictions, such as faculty and medical students?