Public Citizen Petitions OSHA and CMS to Implement Work-Hour Regulations for Resident Physicians
WASHINGTON, D.C. — The Occupational Safety and Health Administration (OSHA) and the Centers for Medicare and Medicaid Services (CMS) must implement evidence-based federal work-hour standards for resident physicians to ensure humane and safe work environments and improve patient safety, according to separate petitions filed today by Public Citizen and the American Medical Student Association (AMSA).
The separate petitions to OSHA and to CMS discuss numerous studies establishing the health risks of excessive work hours to resident physicians and the safety risks to patients. Public Citizen and co-petitioners requested that OSHA and CMS implement the following key regulations for the work hours of resident physicians in all residency and subspecialty fellowship programs:
(1) A limit of 80 hours of work in each and every workweek, without averaging;
(2) A limit of 16 consecutive hours worked in one shift, with no exceptions;
(3) At least one 24-hour period of time off work per week (no averaging) and one 48-hour period of time off work per month, no averaging;
(4) In-hospital on-call frequency no more than once every three nights, no averaging;
(5) A minimum of at least 10 hours off work after a day shift and a minimum of 12 hours off work after a night shift; and
(6) A maximum of four consecutive night shifts with a minimum of 48 hours off after a sequence of three or four night shifts.
No federal agency ensures the right of resident physicians to a safe and healthful workplace, as required for every employee in the United States under the Occupational Safety and Health Act of 1970. Currently, resident physicians are allowed to work up to 88 hours per week (averaged over four weeks), including extended shifts that may last up to 28 consecutive hours.
“Our petition is based on a substantial body of evidence demonstrating that excessive workweeks and extended shifts are harmful to both resident physicians and the patients they care for,” said Nina Zeldes, Ph.D., health researcher at Public Citizen’s Health Research Group. “Resident physicians, like all other employees in the United States, have a right to be protected by federal labor law. Reducing work hours can be an effective tool to mitigate these risks and we know that work hour limitations do not significantly affect the educational and clinical experiences of resident physicians.”
“AMSA is proud to once again be working with Public Citizen to address the critical needs of resident physicians. As the next generation of physicians and resident physicians, we know this work not only directly impacts our future, but also our ability to provide the best care we can to our patients. We strongly endorse this petition for ourselves, our patients, and our communities,” said Nikitha Balaji, AMSA National President.
“There is a critical role for OSHA and CMS in establishing and enforcing federal work-hour standards for the benefit of both doctors in training and their patients,” said Robert Steinbrook, M.D., Director of Public Citizen’s Health Research Group. “In 2025, excessive work hours and extended shifts for resident physicians should not be happening.”
Click here for more information about the petitions and Public Citizen’s previous work on this issue.