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Letter in Internal Medicine News on Resident Work Hours

September 1 2001 • Volume 34 • Number 17
Resident Work Hours Incorrect

A serious error appeared in a graphic that accompanied your recent article “Residents’ Hours Put Students on Picket Line” (July 15, 2001, p. 29). The error gives the appearance that U.S. medical residents’ work hours are not significantly different from those of residents in foreign countries.

The article described the petition that Public Citizen, the American Medical Student Association, and the Committee of Interns and Residents filed with the Occupational Safety and Health Administration to limit house staff hours. The accompanying graphic, which named Public Citizen as the source, compared the number of hours worked by medical residents in a number of other countries and jurisdictions with those worked by U.S. residents. This graphic is not in our petition and was created using an inappropriate selection of data from our petition.

The information on foreign residents in our petition does not apply to the total number of hours that residents actually worked. Rather, our petition tabulated the legislative or regulatory limits on total resident work hours in place in other countries and jurisdictions. We included no information on the extent of compliance with these limits.

Further, the U.S. data depicted in the graphic are incorrect because they include on-call hours only – not total resident work hours. The 57-hour work week that you attributed to U.S. medical residents is a figure apparently taken from a 1991 survey that assessed on-call hours per week only, not total hours worked. Our petition makes it clear that on-call hours are only a subset of a much larger number of total hours.

There is ample evidence that the current U.S. system abuses residents, is likely to lead to adverse patient outcomes, and has not been constrained by the voluntary efforts of organized medicine. That is why OSHA regulation is necessary.

Peter Lurie, M.D. M.P.H., Deputy Director
Sidney M. Wolfe, M.D., Director
Public Citizen’s Health Research Group, Washington

Anandev Gurjala
Northwestern University Chicago