CMS Punts on Work-Hour Reform for Resident Physicians
WASHINGTON, D.C. – The Centers for Medicare and Medicaid Services (CMS) punted on work-hour reforms for resident physicians in its response to a petition from Public Citizen and the American Medical Student Association (AMSA). Currently, resident physicians are allowed to work up to 88 hours per week averaged over four weeks, including extended shifts of up to 28 consecutive hours.
In May 2025, Public Citizen and AMSA separately petitioned the U.S. Occupational Safety and Health Administration (OSHA) and CMS to implement federal work-hour standards for resident physicians that support safe and humane work environments and improve patient safety. In May 2026, CMS responded, stating that the Accreditation Council for Graduate Medical Education (ACGME) “is well-positioned to determine appropriate work-hour requirements in the context of balancing patient safety, educational objectives, and clinical training needs.” OSHA is still reviewing the petition.
“Public Citizen is disappointed that CMS will not set work-hour regulations for resident physicians that would enhance patient safety,” said Robert Steinbrook, M.D., Health Research Group director for Public Citizen. “We urge OSHA to establish and enforce the federal work-hour standards both doctors in training and their patients have needed for years.”
“Although Public Citizen appreciates CMS’s thoughtful review of our petition, the ACGME residency program requirements continue to fall short of the needed evidence-based reforms to protect resident physicians and the patients they care for,” added Nina Zeldes, Ph.D., health researcher at Public Citizen. “The sensible reforms we called for include a limit of 80 hours of work in every workweek, without averaging, a limit of 16 consecutive hours worked in one shift, with no exceptions, and at least one 24-hour period off work per week.”
Public Citizen and co-petitioners previously petitioned OSHA in 2001 and 2010 to regulate the work hours of resident physicians. OSHA denied both petitions.