Wednesday, Oct. 2, 2013
Duty hours compliance remains elusive: Study
The Accreditation Council for Graduate Medical Education (ACGME) first implemented duty hours restrictions for resident physicians in 2003. Despite controversy over the efficacy of the rules, data collected by the ACGME since then has reflected a strong rate of compliance among programs—as high as 95 percent.
However, this figure has been contradicted by numerous published reports tracking resident work hours and anonymous resident surveys that identified frequent noncompliance and underreporting of duty hours. In fact, one study found that 83.6 percent of interns reported duty hours violations.
Brian C. Drolet, MD, and his team of researchers set out to see whether residents and fellows would report similar rates of compliance with the ACGME's new 2011 duty hour standards. Their study, published in the September issue of the Journal of Graduate Medical Education, suggests compliance remains elusive.
Of the 6,202 residents surveyed, 52.9 percent reported some form of noncompliance, and almost as many admitted to falsifying duty hours reports. Residents earlier in their training reported higher rates of noncompliance, perhaps reflecting the difficulty of complying with the new 2011 requirement to cap intern shifts.
The authors believe their data reflects the conflict with which many residents are faced when required to choose between complying with the ACGME's standards and adhering to their ethical and professional standards of practicing medicine. The authors conclude that flexibility in duty hours standards would help and is, in fact, necessary to allow for inevitable patient needs.
At the AMA Annual Meeting, delegates adopted policy recommending that the ACGME use evidence-based approaches to any future revision or introduction of resident duty hours rules. Learn more about the debate over resident duty hours on the AMA Resident and Fellow Section advocacy and policy Web page.
Students, residents leverage Save GME Action Week
Medical students and residents from around the country worked to preserve Medicare funding for graduate medical education (GME) by participating in Save GME Action Week, Aug. 26-30, meeting with their members of Congress in their home district offices.
Fifty medical schools and many residency programs participated in the August campaign, organized by the AMA, which generated more than 40 legislative visits in more than 20 states and more than 7,100 letters sent to Congress via SaveGME.org.
In addition, the AMA Medical Student Section created a companion "America Deserves Doctors" Facebook page that has already received more than 2,000 "likes." Students also were asked to produce a Save GME campaign video in coordination with Rep. Joyce Beatty's office, D-Ohio, and two student op-eds were published by the Columbia Daily Tribune and ABC News.
Since the creation of SaveGME.org last fall, more than 26,000 letters have been sent to Congress through the grassroots website. The site also has received dozens of photos from medical students meeting with their representatives and senators.
To further bolster GME grassroots efforts, the site currently is hosting a GME video contest to encourage students to creatively answer how GME cuts will impact them. The deadline for submission is Nov. 1. Visit SaveGME.org to learn more information about the AMA's GME efforts.