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NEJM Survey: Work Hours Working?

It has been almost two years since the Accreditation Council on Graduate Medical Education (ACGME) duty hour standards were released. The recommendation - note: not regulation - limits first year resident physicians to 16-hour shifts, a decrease from 24 hours.

AMSA continues to say that the recommendations, which permit intermediate-level and senior residents to work 24-hour shifts, are not strong enough and we continue to urge the Occupational Safety and Health Administration, which is tasked with enforcing safety and health legislation, to address resident work hours.

In last week's New England Journal of Medicine, results of a national survey conducted between December 2011 and February 2012, found that residents reported no improvement in education, total number of hours worked, or the amount of rest they were getting. In fact, many participants described the changes as detrimental, with the majority feeling less prepared to take on more-senior roles. Only quality of life for first-year residents was identified as having improved. The frequency of handoffs and workload for senior residents were both noted to have increased, whereas patient safety was deemed to be unchanged. Overall, only 22.9% of residents reported approval of the 2011 regulations. Read more here.

What do you think? Are the recommendations strong enough? What else can be done?

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