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LessTraining Time, Less Fatigue, No Improvement in Patient Safety 2/27/2013 6:46:39 AM
As the governing body for graduate medical/surgical/etc education, the ACGME added new restrictions for first year residents - formerly called interns. After a year of implementaiton, pretty much everybody dislikes the new restrictions and they not to be working as planned. Interns, now called first year residents, can only work sixteen hours at a time. No overnights. No fatigue, or so goes the reasoning. Oh, and, just as when these ACGME folks installed an 80 hour work week, there is no research, no scientific data to support the ACGME's most recent work hour restriction position. Of course, no one wants to work while fatigued. But, if you are going to be a resposive, dedicated doctor you're going to have to rise to the bell when folks get sick. We are training against this altruistic principle.
You have no idea how this 16 hour restriction messes up other residents who have to work harder along with the attending physicians and surgeons. In a recent study, a majority of teachers and trainees felt that patient safety was no better, learning opportunities were worse, and overall contentment with post-graduate training was worse. Surgical residents are disgusted with the restrictions as they miss casses and other learning opportunities. No one has definitively proven that work hour restrictions designed to improve patient safety have accomplished anything at all.
So, why do we persist in following these rules. Because the ACGME is fossilized and inflexible. No one benefits from fearing fatigue except the worst doctors, the ones who don't want to work all that hard in the first place. Our new docs are being trained with the idea that their lifestyle is more important than your heart attack or ruptured bowel.
