US doctors in training to work longer hours under new guidelines

Devices used to take blood pressure, temperature, and examine eyes and ears rest on a wall inside of a doctor's office in New York (Copyright Reuters 2017)

Days may get a lot longer for some doctors in training after the group that oversees medical education in the United States rolled back controversial rules limiting the number of hours first-year residents may work.

Beginning July 1, doctors in their first year of training after medical school may once again care for patients for up to 24 hours at a time and work a total of 80 hours per week, the Accreditation Council for Graduate Medical Education (ACGME) announced on Friday.

In 2011, the group restricted these first-year residents to 16 hours at a stretch over concerns that patient care could suffer if trainees were overly tired.

Opponents at the time argued the restrictions did not protect patients and limited educational opportunities for trainees. Their concerns were largely confirmed by a flurry of new research.

"I think we have a little bit more information through a review of all these studies to say we don't think (cutting first-year resident hours) made a major difference in patient outcomes and experiences," said Dr. Rowen Zetterman, who co-chaired the ACGME task force overseeing the changes.

About one in seven active doctors in the United States is currently in a ACGME-accredited training program, according to the organization.

In addition to rolling back work-hour restrictions on first-year residents, ACGME made changes to reinforce patient safety and physician wellbeing.

At-home work will count toward a trainee's 80-hour maximum, for example. Trainees are also allowed to stay longer on some cases for the benefit of patients and families.

"Once it goes into effect and residents are using it, it'll be viewed favorably," said Dr. Anai Kothari, a member of the task force and a general surgery resident at Loyola University Medical Center in Maywood, Illinois.

The rule change is consistent with the most recent evidence, said Dr. Michael Leitman, senior associate dean for graduate medical education at the Icahn School of Medicine at Mount Sinai in New York. But hospitals might not immediately change trainees' schedules, he said.

"Now that we've been at this for six years, hospitals have learned to develop systems to deal with reduced work hours," Leitman said. A lot of program directors believe a period of adjustment is good for first-year residents, he added.

ACGME will review the new changes in another five years, said Zetterman, a professor at the University of Nebraska Medical Center in Omaha.