Board Expected to Vote on Dangerous Proposal Within the Next Few Weeks
WASHINGTON, D.C. – More than 67,000 petition signatures were delivered today to the Accreditation Council for Graduate Medical Education (ACGME) before its board meets this weekend in Chicago, urging the board to reject a dangerous proposal to roll back limits on work hours for resident doctors. The petitions were gathered by Public Citizen, Care2 and the American Medical Student Association (AMSA).
In November, after intense pressure from the leadership of dozens of physician organizations, a task force of the ACGME − the private organization that sets the rules on resident work hours that are intended to protect the health and safety of both medical residents and patients – issued a proposal to eliminate the current 16-hour shift cap for first-year medical residents and allow them to work 28 or more hours in a row without sleep.
The ACGME board is expected to vote on the proposal within the next few weeks. The new requirements would take effect at the beginning of the next residency academic year, July 2017.
The petitions, delivered today by Care2, come on the heels of a national poll, commissioned by Public Citizen and conducted by Lake Research Partners last summer, which showed that the vast majority of the American public favors restricting the work shifts of medical residents to no more than 16 hours straight without sleep. Importantly, 86 percent of the public is opposed to lifting the 16-hour cap for first-year residents. Moreover, 80 percent of the public supports extending the 16-hour cap to all residents, not just first-year residents.
The November proposal contained other dangerous rule changes including:
- All residents would be permitted to work beyond even the 28-hour shift limit without sleep, without needing to document their reasons for doing so;
- Residents no longer would have any minimum time off after shifts of up to 24 hours; and
- Residents would be permitted to work more than the six consecutive night shifts to which they are currently limited.
The proposal came despite long-standing evidence that medical residents commit more serious medical errors when working shifts of longer than 16 consecutive hours. Residents forced to stay awake for more than 16 consecutive hours also are personally at increased risk for needle-stick injuries, motor vehicle accidents and depression.
“Medical residents are dedicated and hardworking but not superhuman, and, when sleep-deprived, put themselves, their patients and others in harm’s way,” said Dr. Michael Carome, director of Public Citizen’s Health Research Group. “The ACGME board must reject this proposal in the interest of both resident and patient safety.”
In addition to Public Citizen, other organizations have objected to the elimination of the 16-hour shift limit for first-year residents. These include AMSA, the Committee of Interns and Residents (CIR/SEIU Healthcare), the National Physicians Alliance, Consumers Union and dozens of patient, consumer, and public interest groups and advocates.
Dr. Kelly Thibert, AMSA national president, who will begin her residency training this summer, observed, “Extreme sleep deprivation and long hours are a holdover from the early 20th century when residents literally resided in the hospitals in which they trained. There is no reason to continue to subject medical trainees to mental and physical exhaustion for years on end, with the harm that ensues to them, their families and their patients, simply to maintain an archaic tradition.”
Added CIR/SEIU Healthcare president Dr. Eve Kellner, “When I was working at a sleep laboratory before medical school, I saw firsthand the increase in errors and the slowed reaction times resulting from sleep deprivation. So as a patient, I prefer to put my life into the hands of a well-rested physician who would make fewer potentially life-threatening medical errors.”
Lacey Kohlmoos, online organizing strategist for Care2 and the spouse of an incoming first-year resident, noted, “I have seen how long shifts and sleep deprivation can lead to young doctors becoming jaded, chronically tired, completely disconnected from their friends and family, and even suicidal. My husband is about to become a first-year resident, and the ACGME’s proposal makes me fear for his and his patients’ safety and the emotional well-being of our family.”
Read Public Citizen’s comments in December on the ACGME task force’s proposal.
See Public Citizen’s other work on resident work hours.
See a video of former resident Dr. Stephanie Waggel talking about her experience working dangerously long shifts.