Public Citizen AMSA/CIR
|Maximum Hours/week||80 hours||80 hours||125 hours|
|Maximum Shift Length||24 hours||24 hours||36 hour call shifts
16 hour regular shifts
|Minimum Time Off Between Shifts||10 hours after every shift||8 hours after every shift||12 hours only after on call shift|
|Mandatory Time Off||Bill: One 24-hour period every 7 days and 1 full weekend off per month.
Petition: One 24-hour period every 7 days.
|One 24-hour period every 7 days||One 24-hour period every 7 days averaged over 4 weeks.|
|Maximum On-Call Frequency||Every third night||Every third night averaged over 4 weeks||Every third night averaged over 4 weeks|
|Verification Mechanism||Bill: Annual anonymous survey of residents
Bill & Petition: Frequent unannounced inspections
|Defers to the ACGME||Site visits (ranging from every 6 months to once every 5 years)
Annual resident survey
|Hospital/Program Violation Disclosure||Bill: Annual report to Congress on hospital compliance
Petition: Inspection results and work schedules are accessible to public through the Freedom of Information Act
|Enforcement Mechanism||Civil monetary penalties||Defers to ACGME||More frequent review of programs|
 The Association of American Medical Colleges (AAMC), a group representing US medical schools, released their resident work hour policy guidance in October, 2001.
 A 125-hour work week is possible under the ACGME’s proposed guidelines because averaging the on-call frequency over a 4-week period allows for weeks in which residents are on-call every other night. Also, averaging days off over 4 weeks allows for weeks which lack a day off. Therefore, once a month, residents may work a 125-hour week consisting of 3 ½ 36-hour call shifts. When averaged over a month, the ACGME’s standards allow for an average of 104-hour work weeks.
 “Continuous hours during on-call assignments should be limited to 32 hours. Continuous time on duty may be extended to 36 hours at the resident’s request, when the resident has had a minimum of four hours of sleep during the on-call period between 10 pm and 6 am.”