Starting July 1, first-year doctors will have longer shifts. The Accreditation Council for Graduate Medical Education decided Friday that first-year residents will now be allowed to work 24 hours without a break or even 28 hours if the transition between doctors demands it. This means their maximum shift was augmented by 12 hours.

This controversial decision was adopted mainly to benefit the patient because there will be fewer handoffs between doctors. As well, the Accreditation Council for Graduate Medical Education, which oversees training for doctors, said that longer shifts would permit doctors to have a better training since they will follow the evolution of their patients for an extended period. In 2011, the maximum shift for first-year doctors was set in 16 hours, but it generated some issues.

First-year physician
A young physician. Image credit: Shutterstock.

“The Task Force [review panel] has determined that the hypothesized benefits associated with the changes made to the first-year resident scheduled hours in 2011 have not been realized,” the ACGME notes in its announcement of the rule changes, “and the disruption of team-based care and supervisory systems has had a significant negative impact on the professional education of the first-year resident, and effectiveness of care delivery of the team as a whole.”

First-year residents will work 24-to-28 hours without breaks

After establishing in 2011 the 16-hours cap for first-year doctors, the Accreditation Council for Graduate Medical Education announced Friday it would allow interns to work 24 hours straight, and sometimes their shift could be 28-hour-long if the transition between doctors requires it. This decision has been long debated, especially since the 2011 rule didn’t meet the expected results.

They said that this change would enhance the safety of patients, because their doctors will be able to follow them for a longer period, thus reducing handoffs from one doctor to another. As well, the association said that it would reduce problems within the hospitals’ staff and  it will boost the education and training of first-year doctors

Emergency Room
According to Rowen K. Zetterman, co-chairman of a task force that spent two years looking into the issue, they want to be able to say that physicians are highly trained by the end of their residency, so they are ready to go out into practice. Image credit: Cebu Doctors’ University Hospital.

A dangerous decision?

This decision has a lot of opposition since it might not be considering the balance between training and the mental and physical stability of the doctors. However, the Council said that interns won’t be allowed to work more than 80 hours a week. In general, doctors tend to work about 70 hours a week during their careers. The Association also said doctors would have a day off every seven days. As well, hospitals will have to allow them to go to their medical appointments and they will require supervisors to keep an eye on first-year doctors’ wellbeing.

According to Michael Carome, a doctor who heads the Public Citizen’s health research group, this decision is a “dangerous step backward.” He said that it is well known that that sleep-deprived residents are a danger to themselves, their patients and the public. They are likely to commit mistakes and have accidents when they are tired.

There are about 125,000 residents in the United States. They are an essential part of staffs in 800 hospitals.

Source: The Washington Post