ACGME Proposed Limits on Resident Physician Work Hours Are Inadequate

February 11, 2002

View updated table (August 1, 2002)

Read the original petition


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

Whistleblower Protections




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




[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.”