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IOM recommendations for resident hours may affect hospitalist programs

Medical Staff Briefing, April 1, 2009

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In 2003, the Accreditation Council for Graduate Medical Education (ACGME) said it would revisit resident duty hours after five years of experience. In addition, in 2007, the IOM charged the Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedules to Improve Patient Safety to evaluate current work conditions for residents and develop suggestions for improvement. Teaser: Q: What are the Institute of Medicine?s (IOM) recommendations for resident duty hours? A: In 2003, the Accreditation Council for Graduate Medical Education (ACGME) said it would revisit resident duty hours after five years of experience. In addition, in 2007, the IOM charged the Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedules to Improve Patient Safety to evaluate current work conditions for residents and develop suggestions for improvement. According to a brief of its December 2008 report, Resident Duty Hours: Enhancing Sleep, Supervision, and Safety, the IOM recommends that residents still work the current standard of 80 averaged hours per week. However, instead of 30 consecutive hours, the IOM recommends: ? Resident shifts should be no longer than 16 hours. For shifts up to 30 hours, residents should be allowed five hours of protected sleep time after the first 16 awake hours. ? Residency programs should provide residents with adequate time off outside of the hospital between shifts?based on the timing and duration of the shifts?to allow recuperation from sleep deprivation. ? Internal and external moonlighting should be counted against the 80-hour weekly limit. (Currently, the ACGME only counts internal moonlighting against the 80-hour limit.)

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Medical Staff Briefing.

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