Interns Can Now Work 24 Hour Shifts Save

The ACGME has revised its traing guidelines such that, starting July 1st, new interns are allowed to work shifts lasting as long as 24 hours, and as much as 28 hours according to a recent New York Times article.  

The current limts of 16 hours has been in place since the Libby Zion case 3 decades ago, when it was presumed exhausted and inexperienced young doctors were more likely to make medical errors.

The Accreditation Council for Graduate Medical Education has studied the past reduction in hours and shown little or no benefits with regard to patient safety and outcomes.  Moreover, they site the inherent problems of more frequent "patient hand-offs" as one physician transfers care to another "on-call" physician, noting that such transfers may result in safety and management issues for th patient.

Second year residents and beyonds will still be permitted to work 24-hour shifts if necessary.  However the new rules also require that residents not work more than 80 hours a week.

Whether a longer shift are better, has been studied in two randomized trials surgical and internal medicine trainees. They found that shorter shifts had no effect on patient care.

What was found was that continuity of care was better with the longer shifts and that many residents preferred to work longer shifts.