Proposed Limits on Resident Work Hours Inadequate

View updated table (August 1, 2002)

Read the original petition

Public Citizen AMSA/CIR

AAMC

ACGME

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

Whistleblower Protections Yes None None
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

None None
Enforcement Mechanism Civil monetary penalties Defers to ACGME More frequent review of programs


References

[1] The Association of American Medical Colleges (AAMC), a group representing US medical schools, released their resident work hour policy guidance in October, 2001.

[2] 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.   

[3] “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.”